[Persistent leucocytosis as initial manifestation of Whipple's disease and development of gastric cancer in the follow up]. / Leucocitosis persistente como debut de la enfermedad de Whipple con desarrollo de cáncer gástrico en el seguimiento.

We report the case of a 57 year old male with Whipple's disease. The patient was asymptomatic and an unexplained peripheral leucocytosis was found in a routine examination. It persisted as the only abnormality for one year and then he developed articular symptoms, diarrhoea and weight loss. The diagnosis was confirmed by duodenal biopsy five years later. The leucocyte count ranged between 14,000 and 22,000 leuc/mm3. Response to cotrimoxazole was favourable with disappearance of all signs and symptoms, including leucocytosis. In the last endoscopic control, eight years after initial manifestations, an intramucosal gastric adenocarcinoma was diagnosed.