PMID- 22704397
OWN - NLM
STAT- MEDLINE
DCOM- 20130612
LR  - 20120907
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 44
IP  - 10
DP  - 2012 Oct
TI  - Previous immunosuppressive therapy is a risk factor for immune reconstitution 
      inflammatory syndrome in Whipple's disease.
PG  - 880-2
LID - 10.1016/j.dld.2012.05.008 [doi]
AB  - INTRODUCTION: Whipple's disease is a rare chronic infection caused by Tropheryma 
      whipplei. Although most patients respond to antibiotics, in some of them the 
      start of the treatment is followed by recurrence of inflammation. Since 
      polymerase chain reaction is negative for Tropheryma whipplei, this 
      reinflammation cannot be a relapse of Whipple's disease itself. Very recently, it 
      has been recognised as a complication of Whipple's disease and defined immune 
      reconstitution inflammatory syndrome (IRIS). Our aim is to study the prevalence 
      and the clinical features of IRIS in Italian patients with Whipple's disease. 
      METHODS: Evidence of IRIS was retrospectively revaluated in the clinical notes of 
      22 patients with Whipple's disease. Patients with no evidence of IRIS served as 
      controls for the clinical findings. RESULTS: Recurrence of arthralgia and/or 
      fever allowed a diagnosis of IRIS in 5/22 patients. One patient died. Previous 
      immunosuppressive therapy was found in all patients with IRIS but only in 7/17 
      controls (Fisher test, p=0.039). Age at diagnosis and diagnostic delay were 
      higher in patients with IRIS compared to controls. However, statistical 
      significance was not reached. CONCLUSIONS: IRIS is a frequent complication of 
      Whipple's disease and it can be fatal. The risk of IRIS is greatly increased in 
      patients previously treated with immunosuppressive therapy.
CI  - Copyright (c) 2012 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Biagi, Federico
AU  - Biagi F
AD  - Coeliac Centre/First Dept of Internal Medicine, Fondazione IRCCS Policlinico San 
      Matteo, University of Pavia, Italy. f.biagi@smatteo.pv.it
FAU - Trotta, Lucia
AU  - Trotta L
FAU - Di Stefano, Michele
AU  - Di Stefano M
FAU - Balduzzi, Davide
AU  - Balduzzi D
FAU - Marchese, Alessandra
AU  - Marchese A
FAU - Vattiato, Claudia
AU  - Vattiato C
FAU - Bianchi, Paola I
AU  - Bianchi PI
FAU - Fenollar, Florence
AU  - Fenollar F
FAU - Corazza, Gino R
AU  - Corazza GR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120615
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*etiology
MH  - Immunosuppressive Agents/*adverse effects/therapeutic use
MH  - Male
MH  - Polymerase Chain Reaction
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Tropheryma/isolation & purification
MH  - Whipple Disease/*complications/drug therapy
EDAT- 2012/06/19 06:00
MHDA- 2013/06/13 06:00
CRDT- 2012/06/19 06:00
PHST- 2012/03/07 00:00 [received]
PHST- 2012/04/30 00:00 [revised]
PHST- 2012/05/13 00:00 [accepted]
PHST- 2012/06/19 06:00 [entrez]
PHST- 2012/06/19 06:00 [pubmed]
PHST- 2013/06/13 06:00 [medline]
AID - S1590-8658(12)00191-0 [pii]
AID - 10.1016/j.dld.2012.05.008 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2012 Oct;44(10):880-2. doi: 10.1016/j.dld.2012.05.008. Epub 2012 
      Jun 15.