Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease

Abstract Most patients with Whipple’s disease have rheumatic symptoms. The aim of our prospective, questionnaire-based, non-interventional clinical study was to assess whether these symptoms are useful in guiding the differential diagnosis to the rheumatic disorders. Forty patients with Whipple’s di...

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Autores principales:	Gerhard E. Feurle, Verena Moos, Andrea Stroux, Nadine Gehrmann-Sommer, Denis Poddubnyy, Christoph Fiehn, Thomas Schneider
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/38f18a7c41cb42e09112d574f051a491
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spelling	oai:doaj.org-article:38f18a7c41cb42e09112d574f051a4912021-12-02T16:31:11ZDifferential diagnostic value of rheumatic symptoms in patients with Whipple’s disease10.1038/s41598-021-85217-22045-2322https://doaj.org/article/38f18a7c41cb42e09112d574f051a4912021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85217-2https://doaj.org/toc/2045-2322Abstract Most patients with Whipple’s disease have rheumatic symptoms. The aim of our prospective, questionnaire-based, non-interventional clinical study was to assess whether these symptoms are useful in guiding the differential diagnosis to the rheumatic disorders. Forty patients with Whipple’s disease, followed by 20 patients for validation and 30 patients with rheumatoid-, 21 with psoriatic-, 15 with palindromic- and 25 with axial spondyloarthritis were recruited for the present investigation. Patients with Whipple’s disease and patients with rheumatic disorders were asked to record rheumatic symptoms on pseudonymized questionnaires. The data obtained were subjected to multiple logistic regression analysis. Episodic pain with rapid onset, springing from joint to joint was most common in patients with palindromic arthritis and second most common and somewhat less conspicuous in Whipple’s disease. Continuous pain in the same joints predominated in patients with rheumatoid-, psoriatic-, and axial spondyloarthritis. Multiple logistic equations resulted in a predicted probability for the diagnosis of Whipple’s disease of 43.4 ± 0.19% (M ± SD) versus a significantly lower probability of 23.8 ± 0.19% (M ± SD) in the aggregate of patients with rheumatic disorders. Mean area under the curve (AUC) ± SD was 0.781 ± 0.044, 95% CI 0.695–0.867, asymptotic significance p < 0.001. The logistic equations predicted probability for the diagnosis of Whipple’s disease in the initial series of 40 patients of 43.4 ± 0.19% was not significantly different in the subsequent 20 patients of 38.2 ± 0.28% (M ± SD) (p = 0.376). The data may be useful in a predictive algorithm for diagnosing Whipple’s disease. The project is registered as clinical study DRK S0001566.Gerhard E. FeurleVerena MoosAndrea StrouxNadine Gehrmann-SommerDenis PoddubnyyChristoph FiehnThomas SchneiderNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Gerhard E. Feurle Verena Moos Andrea Stroux Nadine Gehrmann-Sommer Denis Poddubnyy Christoph Fiehn Thomas Schneider Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease
description	Abstract Most patients with Whipple’s disease have rheumatic symptoms. The aim of our prospective, questionnaire-based, non-interventional clinical study was to assess whether these symptoms are useful in guiding the differential diagnosis to the rheumatic disorders. Forty patients with Whipple’s disease, followed by 20 patients for validation and 30 patients with rheumatoid-, 21 with psoriatic-, 15 with palindromic- and 25 with axial spondyloarthritis were recruited for the present investigation. Patients with Whipple’s disease and patients with rheumatic disorders were asked to record rheumatic symptoms on pseudonymized questionnaires. The data obtained were subjected to multiple logistic regression analysis. Episodic pain with rapid onset, springing from joint to joint was most common in patients with palindromic arthritis and second most common and somewhat less conspicuous in Whipple’s disease. Continuous pain in the same joints predominated in patients with rheumatoid-, psoriatic-, and axial spondyloarthritis. Multiple logistic equations resulted in a predicted probability for the diagnosis of Whipple’s disease of 43.4 ± 0.19% (M ± SD) versus a significantly lower probability of 23.8 ± 0.19% (M ± SD) in the aggregate of patients with rheumatic disorders. Mean area under the curve (AUC) ± SD was 0.781 ± 0.044, 95% CI 0.695–0.867, asymptotic significance p < 0.001. The logistic equations predicted probability for the diagnosis of Whipple’s disease in the initial series of 40 patients of 43.4 ± 0.19% was not significantly different in the subsequent 20 patients of 38.2 ± 0.28% (M ± SD) (p = 0.376). The data may be useful in a predictive algorithm for diagnosing Whipple’s disease. The project is registered as clinical study DRK S0001566.
format	article
author	Gerhard E. Feurle Verena Moos Andrea Stroux Nadine Gehrmann-Sommer Denis Poddubnyy Christoph Fiehn Thomas Schneider
author_facet	Gerhard E. Feurle Verena Moos Andrea Stroux Nadine Gehrmann-Sommer Denis Poddubnyy Christoph Fiehn Thomas Schneider
author_sort	Gerhard E. Feurle
title	Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease
title_short	Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease
title_full	Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease
title_fullStr	Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease
title_full_unstemmed	Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease
title_sort	differential diagnostic value of rheumatic symptoms in patients with whipple’s disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/38f18a7c41cb42e09112d574f051a491
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Differential diagnostic value of rheumatic symptoms in patients with Whipple’s disease

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