Whipple's arthritis: Direct detection of Tropheryma whippelii in synovial fluid and tissue

J. Desmond O'Duffy, W. Leroy Griffing, Chin Yang Li, Manal F. Abdelmalek, David H. Persing

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

We describe 2 patients presenting with polyarthritis in whom the synovial fluid (1 patient) or synovial tissue (1 patient) was positive for Tropheryma whippelii, the Whipple's disease-associated bacillus, when examined by polymerase chain reaction (PCR) and DNA sequencing. Histopathologic findings were consistent with articular Whipple's disease in the synovial fluid of 1 patient and the synovial tissue of the other. In both patients, bowel mucosal specimens were negative for Whipple's disease features by histologic and PCR methods. One patient was positive for T whippelii in the peripheral blood. Control synovial fluid specimens from 40 patients with other arthritides, including Lyme arthritis, were negative. Sequencing of a 284-basepair region of the 16S ribosomal RNA gene confirmed that the sequence is closely related to the known T whippelii sequence. Both patients responded to treatment with antibiotics.

Original languageEnglish (US)
Pages (from-to)812-817
Number of pages6
JournalArthritis and rheumatism
Volume42
Issue number4
DOIs
StatePublished - Apr 1 1999

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

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