Lack of association with spondyloarthritis and HLA-B27 in Italian patientswith Whipple's disease

Objective. To examine consecutive patients with Whipple's disease (WD) for the full clinical spectrum of spondyloarthritis. Methods. Nine consecutive patients, 8 men, 1 woman, with WD were clinically evaluated and examined for clinical and radiological manifestations of spo ndyloarthritis by 2 rheumatologists with special interest in spondyloarthri tis. The mean age of the patients at the time of study and at the time of t heir 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 anteropos terior radiographic view of the pelvis and also had HLA typing for class I and LI alleles. Pelvis radiographs were read blindly for evidence of sacroi liitis. Results. All but one patient had rheumatologic manifestations related to WD . The mean interval between the onset of these symptoms and the diagnosis o f WD was 6.1 years (range 1-15), One had recurrent polyarthritis, 1 recurre nt oligoarthritis, 3 recurrent monoarthritis, 2 recurrent synovitis with pi tting 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 s welling with pitting edema over the dorsum of hands and/or feet together wi th flexor digit tenosynovitis, 2 also had olecranon bursitis, and 1 tibial tenosynovitis. No patient had clinical or radiological manifestations of sp ondyloarthritis. None had the HLA-B27. Conclusion. In Italian Caucasian patients with WD there was no association with spondyloarthritis and HLA-B27.