Olivieri I, Brandi G, Padula A, Di Stefano M, Mantovani W, Calabrese C, Saccoccio G, Di Febo G, Corazza G R, Miglioli M, Biasco G
Rheumatology Department of Lucania, Ospedale S. Carlo, Contrada Macchia Romana, 85100 Potenza, Italy.
J Rheumatol. 2001 Jun;28(6):1294-7.
To examine consecutive patients with Whipple's disease (WD) for the full clinical spectrum of spondyloarthritis.
Nine consecutive patients, 8 men, 1 woman, with WD were clinically evaluated and examined for clinical and radiological manifestations of spondyloarthritis by 2 rheumatologists with special interest in spondyloarthritis. The mean age of the patients at the time of study and at the time of their initial diagnosis of WD by duodenal biopsy was 62.4 years (range 42-71) and 54.4 years (range 40-62), respectively. Each patient had an anteroposterior radiographic view of the pelvis and also had HLA typing for class I and II alleles. Pelvis radiographs were read blindly for evidence of sacroiliitis.
All but one patient had rheumatologic manifestations related to WD. The mean interval between the onset of these symptoms and the diagnosis of WD was 6.1 years (range 1-15). One had recurrent polyarthritis, 1 recurrent oligoarthritis, 3 recurrent monoarthritis, 2 recurrent synovitis with pitting edema of the dorsum of hands and/or feet, and 1 isolated De Quervain's tenosynovitis. Of the 5 patients with arthritis, 3 also had episodes of swelling with pitting edema over the dorsum of hands and/or feet together with flexor digit tenosynovitis, 2 also had olecranon bursitis, and 1 tibial tenosynovitis. No patient had clinical or radiological manifestations of spondyloarthritis. None had the HLA-B27.
In Italian Caucasian patients with WD there was no association with spondyloarthritis and HLA-B27.
对连续性惠普尔病（WD）患者进行脊柱关节炎全临床谱检查。
9例连续性WD患者，8例男性，1例女性，由2名对脊柱关节炎有特殊兴趣的风湿病学家进行临床评估，并检查脊柱关节炎的临床和放射学表现。研究时患者的平均年龄以及通过十二指肠活检首次诊断WD时的平均年龄分别为62.4岁（范围42 - 71岁）和54.4岁（范围40 - 62岁）。每位患者均拍摄骨盆前后位X线片，并进行I类和II类等位基因的HLA分型。骨盆X线片由专人盲法阅片以寻找骶髂关节炎证据。
除1例患者外，所有患者均有与WD相关的风湿病表现。这些症状出现至WD诊断的平均间隔时间为6.1年（范围1 - 15年）。1例有复发性多关节炎，1例有复发性少关节炎，3例有复发性单关节炎，2例有复发性滑膜炎伴手足背凹陷性水肿，1例有孤立性桡骨茎突狭窄性腱鞘炎。在5例有关节炎的患者中，3例同时有手足背肿胀伴凹陷性水肿发作及屈指腱鞘炎，2例有鹰嘴滑囊炎，1例有胫骨腱鞘炎。无患者有脊柱关节炎的临床或放射学表现。均无HLA - B27。
在意大利白种WD患者中，WD与脊柱关节炎及HLA - B27无关联。
