Whipple disease mimicking inflammatory bowel disease
| Autor: | Maiko Tatsuki, Takashi Ishige, Yoshiko Igarashi, Reiko Hatori, Akira Hokama, Junko Hirato, Aleixo Muise, Takumi Takizawa, Hirokazu Arakawa |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Intestinal Research, Vol 19, Iss 1, Pp 119-125 (2021) |
| Druh dokumentu: | article |
| ISSN: | 1598-9100 2288-1956 |
| DOI: | 10.5217/ir.2019.09177 |
| Popis: | Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acid-Schiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy. |
| Databáze: | Directory of Open Access Journals |
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