Joana Cardoso1, Lídia Gomes2, Sandra Santos1, Hélder Moreira3, Paula Gomes4, João Rua1, Jorge Fortuna1. 1. Department of Internal Medicine, Coimbra University and Hospital Centre, Coimbra, Portugal. 2. Department of Pneumology, Coimbra University and Hospital Centre, Coimbra, Portugal. 3. Department of Anatomic Pathology, Coimbra University and Hospital Centre, Coimbra, Portugal. 4. Department of Imagiology, Coimbra University and Hospital Centre, Coimbra, Portugal.
Abstract
INTRODUCTION: Whipple's disease is a rare, chronic, systemic disease caused by the actinomycete Tropheryma whipplei. Clinical manifestations vary widely depending on the affected system, the most common being the digestive tract. CASE PRESENTATION: The authors report the case of a 52-year-old man with malabsorption syndrome, diarrhea, marked weight loss, melanoderma, and visual and proprioception disorders. Periodic acid-Schiff staining of a proximal small bowel biopsy and peripheral-blood PCR identification of T. whipplei confirmed the disease. The patient was initially treated with intravenous ceftriaxone, followed by oral trimethoprim/sulfamethoxazole with significant clinical improvement. CONCLUSIONS: This case is reported due to its rarity and the diagnostic challenge it presents. Although uncommon, Whipple's disease should be considered as a differential diagnosis of malabsorption syndrome due to its systemic impact and possible treatment with targeted antibiotic therapy.
INTRODUCTION: Whipple's disease is a rare, chronic, systemic disease caused by the actinomycete Tropheryma whipplei. Clinical manifestations vary widely depending on the affected system, the most common being the digestive tract. CASE PRESENTATION: The authors report the case of a 52-year-old man with malabsorption syndrome, diarrhea, marked weight loss, melanoderma, and visual and proprioception disorders. Periodic acid-Schiff staining of a proximal small bowel biopsy and peripheral-blood PCR identification of T. whipplei confirmed the disease. The patient was initially treated with intravenous ceftriaxone, followed by oral trimethoprim/sulfamethoxazole with significant clinical improvement. CONCLUSIONS: This case is reported due to its rarity and the diagnostic challenge it presents. Although uncommon, Whipple's disease should be considered as a differential diagnosis of malabsorption syndrome due to its systemic impact and possible treatment with targeted antibiotic therapy.
Authors: Isabel A Hujoel; David H Johnson; Benjamin Lebwohl; Daniel Leffler; Sonia Kupfer; Tsung-Teh Wu; Joseph A Murray; Alberto Rubio-Tapia Journal: Dig Dis Sci Date: 2018-03-23 Impact factor: 3.199
Authors: Jan Bureš; Marcela Kopáčová; Tomáš Douda; Jolana Bártová; Jan Tomš; Stanislav Rejchrt; Ilja Tachecí Journal: Gastroenterol Res Pract Date: 2013-06-17 Impact factor: 2.260