Whipple’s disease
Abstract
The aim of clinical case presentation. To show features of clinical manifestations of Whipple’s disease, its treatment; to compare to literature data to the authors’ two-years experience of patient observation.
Clinical case features. The Whipple’s disease of typical course is diagnosed for the 56 years-old patient with characteristic signs of diarrhea, loss of body weight, other malabsorption signs and joints involvement. Complexity of the Whipple’s disease diagnosis was related to the fact that extraintestinal signs developed long ahead to clinical signs which dominated in the developed stage of disease. Founding of macrophages with PAS-positive granules at histological study mucosa of the small intestine was decisive for diagnosis. Moderately severe persistent articular involvement after treatment by co-trimoxazole 960 mg/day for 4 months with the subsequent interchange of co-trimoxazole and erythromycin 1000 mg/day (for 2 weeks each agent) determined complexity of management in presented case that required prolongation of antibacterial therapy.
Conclusion. Whipple’s disease should be suspected at presence of malabsorption signs combined to lesions of joints, cardio-vascular, respiratory and nervous system. The diagnosis is verified by revealing of macrophages containing PAS-positive granules in lymph nodes and the intestine.
About the Authors
I. V. MayevRussian Federation
Ye. V. Zhilyaev
Russian Federation
D. T. Dicheva
Russian Federation
T. A. Buragina
Russian Federation
O. Ye. Berezutskaya
Russian Federation
N. L. Golovkina
Russian Federation
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Review
For citations:
Mayev I.V., Zhilyaev Ye.V., Dicheva D.T., Buragina T.A., Berezutskaya O.Ye., Golovkina N.L. Whipple’s disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(5):80-85. (In Russ.)
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