Table 4.
General, clinical, biological, imaging and therapeutic features according to classic versus non classic Whipple disease.
| CWD N = 11 |
NCWD N = 57 |
P value | |
|---|---|---|---|
| General characteristics n/N (%) | |||
| Male | 9/11 (82) | 47/57 (82) | 0.624 |
| Median age at diagnosis, years [range] | 60 [34–79] | 60 [30–80] | 0.764 |
| Familial history of autoimmunity | 3/8 (38) | 13/46 (28) | 0.441 |
| First-degree familial history of Whipple disease | 1/8 (13) | 3/46 (6.5) | 0.484 |
| Median duration before diagnosis, years [range] | 7 [0–16] | 4 [0–40] | 0.640 |
| Alternative diagnosis | 7/9 (78) | 44/50 (88) | 0.352 |
| Clinical features n/N (%) | |||
| Abdominal pain | 3/11 (27) | 8/57 (14) | 0.247 |
| Weight loss | 10/11 (91) | 19/54 (35) | 0.001 |
| Diarrhoea | 6/11 (55) | 14/57 (25) | 0.046 |
| Arthritis | 10/11 (91) | 50/57 (88) | 0.617 |
| Hip arthritis | 2/11 (18) | 1/57 (1.8) | 0.066 |
| Inflammatory arthralgia | 11/11 (100) | 51/57 (89) | 0.332 |
| Intermittent | 4/8 (50) | 38/45 (84) | 0.048 |
| Axial +/− peripheral involvement | 6/11 (55) | 36/57 (63) | 0.590 |
| Fever | 5/11 (45) | 11/56 (20) | 0.066 |
| Adenopathy | 4/10 (40) | 11/55 (20) | 0.164 |
| Pleural effusion | 1/11 (9.1) | 1/57 (1.8) | 0.299 |
| Pericarditis | 0/11 (0) | 6/37 (16) | 0.332 |
| Endocarditis | 1/11 (9.1) | 2/57 (3.5) | 0.416 |
| Neurological symptoms | 0/11 (0) | 4/57 (7.0) | 0.485 |
| Uveitis | 1/11 (9.1) | 1/57 (1.8) | 0.299 |
| Melanoderma | 0/11 (0) | 4/57 (7.0) | 0.485 |
| Biological features n/N (%) | |||
| Elevated CRP | 10/11 (91) | 53/57 (93) | 0.598 |
| Median CRP mg/l[range] | 80 [52–237] | 56 [9–235] | 0.016 |
| Median albuminemia g/l [range] | 29 [23–35] | 38 [21–45] | 0.001 |
| Anaemia | 9/11 (82) | 18/55 (33) | 0.004 |
| Thrombocytosis | 6/11 (55) | 11/54 (20) | 0.019 |
| Polynucleosis | 4/11 (36) | 23/56 (41) | 0.524 |
| RF | 0/11 (0) | 5/50 (10) | 0.356 |
| Anti-CCP | 0/11 (0) | 0/48 (0) | 0 |
| HLA B27 | 2/5 (40) | 6/24 (25) | 0.425 |
| ANA > = 1/160 | 2/11 (18) | 15/51 (29) | 0.364 |
| ANCA | 1/6 (17) | 1/26 (3.8) | 0.345 |
| Imaging features n/N (%) | |||
| Joint space narrowing | 4/7 (57) | 12/34 (35) | 0.254 |
| Radiographic erosions | 4/10 (40) | 6/46 (13) | 0.066 |
| Immunosuppressive treatment n/N (%) | |||
| Glucocorticoids | 8/11 (73) | 30/49 (61) | 0.363 |
| csDMARD | 8/11 (73) | 34/56 (61) | 0.347 |
| Biologic | 5/11 (45) | 15/56 (27) | 0.216 |
| Evolution after antibiotherapy n/N (%) | |||
| IRIS | 2/11 (18) | 3/53 (5.7) | 0.201 |
| Relapse | 5/11 (45) | 16/54 (30) | 0.306 |
| Evolution towards chronic rheumatism | 2/11 (18) | 5/53 (9.4) | 0.345 |
ANA antinuclear antibodies; CWD classic Whipple disease; csDMARD conventional synthetic disease-modifying antirheumatic drug; IRIS Immune reconstitution inflammatory syndrome; NCWD nonclassic Whipple disease; RF rheumatoid factor.