Whipple's disease: rare disorder and late diagnosis

Revista do Instituto de Medicina Tropical de São Paulo

Viviane Plasse Renon²  Marcelo Campos Appel-da-silva²  Rafael Bergesch D'incao²  Rodrigo Mayer Lul²  Luciana Schmidt Kirschnick¹  Bruno Galperim² 

[1] ,Hospital Nossa Senhora da Conceição Department of Gastroenterology Porto Alegre RS ,Brazil

关键词: Whipple's disease;    Tropheryma whipplei;    Malabsorption syndromes;   

DOI  :  10.1590/S0036-46652012000500010

来源: SciELO

【 摘 要 】

Whipple's disease is a rare systemic infectious disorder caused by the bacterium Tropheryma whipplei. We report the case of a 61-year-old male patient who presented to emergency room complaining of asthenia, arthralgia, anorexia, articular complaints intermittent diarrhea, and a 10-kg weight loss in one year. Laboratory tests showed the following results: Hb = 7.5 g/dL, albumin = 2.5 mg/dL, weight = 50.3 kg (BMI 17.4 kg/m²). Upper gastrointestinal endoscopy revealed areas of focal enanthema in the duodenum. An endoscopic biopsy was suggestive of Whipple's disease. Diagnosis was confirmed based on a positive serum polymerase chain reaction. Treatment was initiated with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole. After one year of treatment, the patient was asymptomatic, with Hb = 13.5 g/dL, serum albumin = 5.3 mg/dL, and weight = 70 kg (BMI 24.2 kg/m²). Whipple's disease should be considered a differential diagnosis in patients with prolonged constitutional and/or gastrointestinal symptoms. Appropriate antibiotic treatment improves the quality of life of patients.

【 授权许可】

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