Whipple's Disease in a 61-Year-Old Patient. Clinical Follow-Up
https://doi.org/10.22416/1382-4376-2024-34-2-91-100
Abstract
Aim: to present a clinical observation of a patient with Whipple's disease, demonstrating the difficulties in diagnosing the disease.
Key points. A clinical observation of Whipple's disease in a 61-year-old man is described. The onset of the disease was manifested as polyarthritis three years before diagnosis. The further course of the disease occurred during the pandemic of a new coronavirus infection COVID-19, which made the diagnostic search difficult. Clinical manifestations of fever, arthralgias, diarrhea, lymphadenopathy, anaemia and weight loss raised suspicion of Whipple's disease. Key to the diagnosis were endoscopic studies with multiple small bowel biopsies, which allowed histological identification of PAS-positive macrophages in the small bowel mucosa. Therapy with ceftriaxone for 14 days, therapy with trimethoprim-sulfamethoxazole (160 mg/800 mg twice a day) for 14 months resulted in positive clinical dynamics, improvement of laboratory parameters, disappearance of PAS-positive macrophages in the small intestinal mucosa, indicating remission of the disease.
About the Authors
Zh. G. Simonova
Kirov State Medical University
Russian Federation
Russian Federation
Zhanna G. Simonova — Dr. Sci. (Med.), Docent, Head of the Department of Hospital Therapy
610998, Kirov, Karla Marksa str., 112
О. V. Pestereva
Kirov State Medical University
Russian Federation
Russian Federation
Olga V. Pestereva — Postgraduate at the Department of Hospital Therapy
610998, Kirov, Karla Marksa str., 112
D. A. Dyakonov
Kirov Research Institute of Haematology and Blood Transfusion of the Federal Medical and Biological Agency
Russian Federation
Russian Federation
Dmitry A. Dyakonov — Cand. Sci. (Med.), Head of the Pathology Laboratory
610027, Kirov, Krasnoarmeyskaya str., 72
М. А. Karepanov
Kirov Regional Clinical Hospital
Russian Federation
Russian Federation
Maksim A. Karepanov — Head of the Gastroenterology Department
610027, Kirov, Vorovskogo str., 42
М. S. Ralnikova
Kirov Regional Clinical Hospital
Russian Federation
Russian Federation
Maria S. Ralnikova — Gastroenterologist of the Gastroenterology Department
610027, Kirov, Vorovskogo str., 42
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Review
For citations:
Simonova Zh.G., Pestereva О.V., Dyakonov D.A., Karepanov М.А., Ralnikova М.S. Whipple's Disease in a 61-Year-Old Patient. Clinical Follow-Up. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2024;34(2):91-100. https://doi.org/10.22416/1382-4376-2024-34-2-91-100
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