Elsa Prudent1, Guillaume Le Guenno2, Stijn Jonckheere3, Anne Vankeerberghen3, Hubert Lepidi1, Emmanouil Angelakis4,5, Didier Raoult1. 1. Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13005, Marseille, France. 2. Department of Internal Medicine, Hôpital Estaing, Centre, Hospitaliser Universitaire, Clermont-Ferrand, France. 3. Laboratory of Clinical Microbiology, OLV Hospital Aalst, Aalst, Belgium. 4. Aix Marseille Université, IRD, APHM, VITROME, IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13005, Marseille, France. e.angelakis@hotmail.com. 5. Laboratory of Medical Microbiology, Hellenic Pasteur Institute, Athens, Greece. e.angelakis@hotmail.com.
Abstract
BACKGROUND: Immunohistochemistry and Periodic acid-Schiff (PAS) staining have been routinely used for the diagnosis of Whipple's disease (WD). However, these methods present limitations. As a result, the last years, Fluorescence in situ hybridization (FISH) has been increasingly used as a complementary tool for the diagnosis of WD from various tissue samples. CASE REPORT: In this study, we visualized, by FISH, Tropheryma whipplei within macrophages of a lymph node from a patient with WD. Moreover, we report in this study a patient with a pulmonary biopsy compatible with WD by PAS, immunostaining and FISH, although the specific molecular assays for T. whipplei were negative. Sequencing analysis of the 16S rDNA revealed a T. whipplei-related species with unknown classification. CONCLUSION: FISH can be a valuable method for the detection of Tropheryma species in formalin-fixed paraffin-embedded tissues. FISH cannot replace the other already approved diagnostic techniques for WD, it can be used as a complementary tool and can provide supplementary information in a relatively short time.
BACKGROUND: Immunohistochemistry and Periodic acid-Schiff (PAS) staining have been routinely used for the diagnosis of Whipple's disease (WD). However, these methods present limitations. As a result, the last years, Fluorescence in situ hybridization (FISH) has been increasingly used as a complementary tool for the diagnosis of WD from various tissue samples. CASE REPORT: In this study, we visualized, by FISH, Tropheryma whipplei within macrophages of a lymph node from a patient with WD. Moreover, we report in this study a patient with a pulmonary biopsy compatible with WD by PAS, immunostaining and FISH, although the specific molecular assays for T. whipplei were negative. Sequencing analysis of the 16S rDNA revealed a T. whipplei-related species with unknown classification. CONCLUSION: FISH can be a valuable method for the detection of Tropheryma species in formalin-fixed paraffin-embedded tissues. FISH cannot replace the other already approved diagnostic techniques for WD, it can be used as a complementary tool and can provide supplementary information in a relatively short time.
Authors: Walter Geissdörfer; Verena Moos; Annette Moter; Christoph Loddenkemper; Andreas Jansen; René Tandler; Andreas J Morguet; Florence Fenollar; Didier Raoult; Christian Bogdan; Thomas Schneider Journal: J Clin Microbiol Date: 2011-11-30 Impact factor: 5.948
Authors: M Maiwald; A von Herbay; D H Persing; P P Mitchell; M F Abdelmalek; J N Thorvilson; D N Fredricks; D A Relman Journal: Ann Intern Med Date: 2001-01-16 Impact factor: 25.391