whipple’s disease
Clicks: 9
ID: 159372
2009
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Abstract
Background Whipple’s disease is a chronic, multisystemic disease caused by a microorganism named
Tropheryma whipplei. Disease is rare, so it presents a diagnostic problem to clinicians.
Long-term treatment with antibiotics is successful. We report two patients with longstanding
complaints and accurate histopathological diagnosis further on confirmed by molecular
biology test.
Methods Both patients presented with malaise, weight loss and laboratory parameters of chronic
infection. Since rheumatological, haemathological and infective causes of complaints
were ruled out, patients were admitted to our hospital. Histopathological examination in
both cases confirmed Whipple’s disease and antibiotic treatment was started. Polymerase chain reaction using specific oligonucleotide primers for 16S rRNA was performed on
formalin-fixed, paraffin-embedded tissue samples of both patients and peripheral blood of
one patient.
Results One patient presented with advanced disease and despite antibiotic treatment he died
with signs of pulmonary arterial hypertension. The other patient was diagnosed early in
the course of the disease and antibiotic treatment was effective. In tissue samples of both
patients we found PAS-positive intracellular bacilli. By PCR method we detected a specific
gene segment of Tropheryma whipplei in tissue samples and peripheral blood.
Conclusions Presented two cases confirm the rarity of Whipple’s disease and illustrate the variety of
nonspecific clinical findings which lead to late diagnosis. Histopathological changes are
very specific on PAS staining. Molecular biology test aids in disease confirmation.
| Reference Key |
kern2009zdravnikiwhipples
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|---|---|
| Authors | ;Izidor Kern;Katarina Osolnik;Viktorija Tomič;Viktor Uršič |
| Journal | planta medica |
| Year | 2009 |
| DOI |
DOI not found
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| URL | |
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