Highlights
- •We previously noted H. pylori-related complications in patients with Whipple disease.
- •We found here that H. pylori is more common in Whipple disease than controls.
- •In Whipple disease, H. pylori should also be tested for during follow-up.
- •No patients on doxycycline developed H. pylori infection.
- •This should be considered when selecting antibiotics for long-term prophylaxis.
Abstract
Introduction
Whipple's disease is a rare systemic infection due to an impaired immunological response
against T. whipplei in genetically predisposed individuals. Since we previously noted development of
H. pylori related complications in some patients with Whipple's disease, our aim was to study
the prevalence of H. pylori infection and H. pylori related disorders in Whipple's disease.
Methods
Whipple's disease patients diagnosed from Jan-2002 to Dec-2021 and two controls per
patient, matched for age, gender, ethnicity and year of H. pylori testing were enrolled.
Results
34 patients with Whipple's disease and 68 controls were enrolled. H. pylori infection (13/34 vs 8/68, p<0.01), H. pylori-related gastritis (p<0.01) and gastric atrophy (p = 0.01) were significantly more common in patients with Whipple's disease than controls.
H. pylori infection and Whipple's disease were diagnosed synchronously in 6/13 patients, and
during follow-up in the remaining 7. Interestingly, these last 7 patients were all
on trimethoprim-sulfamethoxazole long-term therapy. Two patients developed H. pylori-related gastric malignancies during follow-up. No patients on doxycycline developed
H. pylori infection.
Conclusions
H. pylori infection and related disorders are common in patients with Whipple's disease and
should always be excluded both at time of diagnosis and during follow-up. These findings
should be taken into account when selecting antibiotics for Whipple's disease long-term
prophylaxis.
Keywords
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Article info
Publication history
Published online: February 21, 2023
Accepted:
February 15,
2023
Received in revised form:
February 7,
2023
Received:
January 13,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
