Whipple's disease. Report of five cases with different clinical features
Rev. Inst. Med. Trop. Säo Paulo
;
43(1): 45-50, Jan.-Feb. 2001. ilus
Article
in English
| LILACS
| ID: lil-285680
ABSTRACT
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
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Whipple Disease
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. Inst. Med. Trop. Säo Paulo
Journal subject:
Tropical Medicine
Year:
2001
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Federal University of Minas Gerais/BR
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