Whipple's disease. Report of five cases with different clinical features

Autor: FERRARI Maria de Lourdes de Abreu, VILELA Eduardo Garcia, FARIA Luciana Costa, COUTO Claudia Alves, SALGADO Célio Jefferson, LEITE Virgínia Rios, BRASILEIRO FILHO Geraldo, BAMBIRRA Eduardo Alves, MENDES Claudia Maria de Castro, CARVALHO Silas de Castro, OLIVEIRA Celso Affonso de, CUNHA Aloísio Sales da
Jazyk: angličtina
Rok vydání: 2001
Předmět:
Zdroj: Revista do Instituto de Medicina Tropical de São Paulo, Vol 43, Iss 1, Pp 45-50 (2001)
Druh dokumentu: article
ISSN: 0036-4665
1678-9946
Popis: Whipple's disease (WD) is a rare systemic disease of infectious etiology which involves the small intestine but can virtually affect any organ. We present here five cases (four males and one female) ranging in age from 20 to 59 years. All patients had intestinal involvement associated or not with clinical manifestations linked to this organ. Vegetation in the tricuspid valve was observed in one patient, suggesting endocarditis caused by Tropheryma whippelii, with disappearance of the echocardiographic alterations after treatment. In one of the male patients the initial clinical manifestation was serologically negative spondylitis, with no diarrhea occurring at any time during follow-up. Ocular involvement associated with intestinal malabsorption and significant weight loss were observed in one case. In the other two cases, diarrhea was the major clinical manifestation. All patients were diagnosed by histological examination of the jejunal mucosa and, when indicated, of extraintestinal tissues by light and electron microscopy. After antibiotic treatment, full remission of symptoms occurred in all cases. A control examination of the intestinal mucosa performed after twelve months of treatment with sulfamethoxazole-trimethoprim revealed the disappearance of T. whippelii in four patients. The remaining patient was lost to follow-up.
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