Whipple disease – two case reports

Czech version

Authors: Šurinová J.; Straka L.
Authors‘ workplace: Gastroenterologická ambulance, Uherskohradišťská nemocnice a. s.
Published in: Gastroent Hepatol 2020; 74(4): 334-338
Category:
doi: https://doi.org/10.14735/amgh2020334

Overview

We present two cases of our patients examined for weight loss, arthralgia and diarrhea, who were diagnosed with Whipple disease. Whipple disease is a rare chronic systemic illness, nevertheless it can be found in the ordinary clinical practice. Symptoms of this disease are not generally specific ones. The diagnosis is based on gastroscopic findings of duodenal mucosal atrophy with enlarged lymphatics, typical histological findings and polymerase chain reaction verification of Tropheryma whipplei. If we consider the disease in the differential diagnosis, an antibiotic treatment is almost always successful. To reduce the risk of relapse, such treatment should be carried out on a long-term basis.

Conflict of Interest: The authors declare that the article/manuscript complies with ethical standards, patient anonymity has been respected, and they state that they have no financial, advisory or other commercial interests in relation to the subject matter.

Publication Ethics: This article/manuscript has not been published or is currently being submitted for another review. The authors agree to publish their name and e-mail in the published article/ manuscript.

Dedication: The article/manuscript is not supported by a grant nor has it been created with the support of any company.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio medical papers.

Keywords:

endoscopy – Whipple disease – malabsorption syndromes – Tropheryma whipplei

Sources

1. Kopáčová M. Nemoci tenkého střeva. In: Lata J,Bureš J, Vaňásek T (eds) et al. Gastroenterologie. 1. vyd. Praha: Galén 2010: 80–81.

2. Kohout P. Whippleova choroba. In: Lukáš K, Hoch J (eds). Nemoci střev. 1. vyd. Praha: Grada 2018: 208–209.

3. Frič P, Dvořák M, Mařatka Z et al. Jiné nemoci tenkého střeva. In: Mařatka Z. Gastroenterologie. 1. vyd. Praha: Karolinum 1999: 215–216.

4. Saito H, Shiode J, Ohya S et al. Whipple’s disease with long-term endoscopic follow-up. Intern Med 2018; 57 (12): 1707–1713. doi: 10.2169/internalmedicine.9631-17.

5. Dolmans RA, Boel CH, Lacle MM et al. Clinical manifestation, treatment and diagnosis of tropheryma whipplei infections. Clin Microbiol Rev 2017; 30 (2): 529–555. doi: 10.1128/CMR.00033-16.

6. De Francesco V, Corsi F, Pennella A et al. Whipple’s disease: case report and review of the literature. J Gastrointestin Liver Dis 2018; 27 (3): 331–336. doi: 10.15403/jgld.2014.1121.273.fra.

7. Dutly F, Altwegg M. Whipple’s disease and „Tropheryma whippelii“. Clin Microbiol Rev 2001; 14 (3): 561–583. doi: 10.1128/CMR.14.3 561–583.2001.

8. Dymon I, Tabaka-Pradela J, Knast K et al.Neurological and neuropsychological complications in the course of chronic Whipple’s disease – case report. Psychiatr Pol 2017; 51 (5): 953–961. doi: 10.12740/PP/OnlineFirst/61131.

9. Bureš J, Kopáčová M, Douda T et al. Whipple’s disease: our own experience and review of the literature. Gastroenterol Res Pract 2013; 2013: 478349. doi: 10.1155/2013/478349.

10. Glaser C, Rieg S, Wiech T et al. Whipple’sdisease mimicking rheumatoid arthritis can cause misdiagnosis and treatment failure. Orphanet J Rare Dis 2017; 12 (1): 99. doi: 10.1186/s13023-017-0630-4.

11. Schöniger-Hekele M, Petermann D, Weber B et al. Tropheryma whipplei in the environment: survey of sewage plant influxes and sewage plant workers. Appl Environ Microbiol 2007; 73 (6): 2033–2035. doi: 10.1128/AEM.02335-06.