A unique posterior segment manifestation of whipple disease.

PURPOSE: To report a novel posterior segment manifestation of Whipple disease. METHOD: Single observational case study. RESULTS: The white crystalline deposit in the retina, choroiditis, and vitritis resolved with treatment of Whipple disease. CONCLUSION: Whipple disease can be associated with panuveitis, multifocal choroiditis, and white crystalline deposits in the anterior segments and retina, a unique clinical finding.

Whipple's disease-associated pulmonary hypertension with positive vasodilator response despite severe hemodynamic derangements.

Pulmonary hypertension (PH) associated with Whipple's disease (WD-PH) is extremely rare, and the underlying pathophysiological processes are incompletely understood. Alterations in hemodynamics can be severe, with right ventricular (RV) dysfunction being common. A case involving a 23-year-old man with WD-PH who exhibited a dramatic vasodilator response during right heart catheterization despite severely altered pulmonary hemodynamics and concomitant RV dysfunction is reported. While the patient's symptoms responded poorly to treatment with nifedipine and sildenafil, significant improvement in dyspnea, RV dysfunction and pulmonary pressures were noted following antibiotic therapy. The present report highlights that despite severely elevated pulmonary artery pressures and RV dysfunction in WD-PH patients, a highly significant vasodilator response and dramatic improvement with antibiotic therapy may be observed. Furthermore, the case highlights the phenomenon of PH in the setting of inflammation, suggesting that adequate control of the inflammatory response can be accompanied by a marked improvement in hemodynamics in certain types of PH.