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Detection and Characteristic of Whipple Diseases in the Great Britany

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StatusConcluído
Patrocinadores
University Hospital, Brest

Palavras-chave

Resumo

Whipple's disease is a chronic systemic infection caused by ubiquitous bacterium Tropheryma wipplei on a genetic predisposition which should be considered in patients with recurrent episodes of seronegative arthritis, erosive or not, or inflammatory low back pain, chronic diarrhea, persistent fever, unexplained neurological signs, uveitis, endocarditis, and epithelioid granuloma.
Laboratory tests may show malabsorption, erythrocyte sedimentation rate and C-reactive protein elevation, anemia, thrombocytosis, eosinophilia and lymphopenia.
None of theses findings is specific and most patients have arthritis or low back pain mimicking rheumatoid arthritis and spondyloarthritis.
As the disease is rare, chance for positive polymerase chain reaction testing for Tropheryma whipplei is low in this context.

datas

Última verificação: 01/31/2018
Enviado pela primeira vez: 11/16/2017
Inscrição estimada enviada: 11/20/2017
Postado pela primeira vez: 11/21/2017
Última atualização enviada: 02/11/2018
Última atualização postada: 02/12/2018
Data real de início do estudo: 11/14/2017
Data Estimada de Conclusão Primária: 02/08/2018
Data Estimada de Conclusão do Estudo: 02/08/2018

Condição ou doença

Whipple Disease

Fase

-

Grupos de Armas

BraçoIntervenção / tratamento
Classic Whipple's disease (CWD)
Classic Whipple's disease (CWD), defined as duodenal biopsy positive by PAS/immunohistochemistry or blood positive by PCR
Focal Whipple's disease (FWD)
Focal Whipple's disease (FWD), defined as joint fluid positive by PCR but duodenal biopsy negative by PAS/immunohistochemistry
Chronic T. whipplei-associated arthritis (CTWA)
Chronic T. whipplei-associated arthritis (CTWA) defined as chronic arthritis and duodenal biopsy, stool, or saliva positive by PCR duodenal biopsy negative by PAS/immunohistochemistry joint fluid negative by PCR

Critério de eleição

Idades qualificadas para estudar 18 Years Para 18 Years
Sexos elegíveis para estudoAll
Método de amostragemProbability Sample
Aceita Voluntários Saudáveissim
Critério

Inclusion Criteria:

- Adult

- patient with at least a screening test for Whipple'disease

- participation agreement,

Exclusion Criteria:

- No test for Whipple'disease

Resultado

Medidas de Resultado Primário

1. Number of patients diagnosed as whipple's disease [Day 0 ( Date of diagnostic)]

Diagnosis of Whipple's disease based on at least one suggestive clinical finding at least one test detecting T. Whipplei diagnosis made by a specialist a dramatic and persistent response to antibiotic therapy Hydroxychloroquine 200mgx2 plus Doxycycline 100mgx2 or trimethoprim/sulfamethoxazole 800/160mg x2

Medidas de Resultado Secundário

1. Number of test performed in each centre [Day 0 (Date of diagnostic)]

Number of diagnoses according to tests Patients will be divided into three groups Classic Whipple's disease (CWD), defined as : duodenal biopsy positive by PAS/immunohistochemistry or blood positive by PCR Focal Whipple's disease (FWD) joint fluid positive by PCR but duodenal biopsy negative by PAS/immunohistochemistry Chronic T. whipplei-associated arthritis (CTWA): chronic arthritis and duodenal biopsy, stool, or saliva positive by PCR duodenal biopsy negative by PAS/immunohistochemistry joint fluid negative by PCR

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