Year 2024 / Volume 116 / Number 3
Digestive Diseases Image
Whipple’s disease – A typical endoscopic finding of a rare disease

157-158

DOI: 10.17235/reed.2022.9338/2022

Ana Valadas, Narcisa Fatela, Tiago Sepúlveda Santos, Maria Leonor Carvalho,

Abstract
A 49-year-old female presented with a 5-month course of diarrhoea, nocturn abdominal pain, asthenia, and weight loss of 30% of her body mass in three months. The patient had also a four-year medical history of bilateral mechanic gonalgy and arthralgias of the metacarpophalangeal and interphalangeal joints, despite treatment with prednisolone. On examination the patient had hyperpigmentation of the face and thorax, low-grade fever, and a BMI of 15,8 Kg/m2. Diarrhoea was documented with watery stools seven times per day despite loperamide, brownish, with no visible blood or mucous. Since the upper GI endoscopy and colonoscopy had no macroscopic abnormalities, the patient underwent a capsule endoscopy, which revealed continuous mucosal lesion with lymphangiectasia, oedema, villous atrophy and areas of denudation with hematinic punctate from the duodenum to the ileum. Diagnosis of Whipple’s Disease was made with typical histology findings in duodenum material and a positive PCR for Tropheryma whipplei.
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12/03/2024 18:02:42
es una de las problemas digestivos se se ven muy poco en la consulta , pero los pocos que se dan por aca en mi pais mejoran con ila rifaximina


References
[1] – Capsule endoscopy in Whipple’s Disease; Roulet J, Hassan M, Cummings L; Clin Gastroenterol Hepatol. 2013 Nov; 11(11): A26
[2] - Intravenous ceftriaxone, followed by 12 or three months of oral treatment with trimethoprim-sulfamethoxazole in Whipple's disease; Feurle G et al; J Infect. 2013 Mar;66(3):263-70
[3] - Whipple’s disease: new aspects of pathogenesis and treatment; Schneider T, Moos V, Loddenkemper C, Marth T, Fenollar F, Raoult D; Lancet Infectious Diseases. 2008; 8(3):179
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Valadas A, Fatela N, Sepúlveda Santos T, Carvalho M. Whipple’s disease – A typical endoscopic finding of a rare disease. 9338/2022


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Publication history

Received: 07/11/2022

Accepted: 18/11/2022

Online First: 01/12/2022

Published: 04/03/2024

Article Online First time: 24 days

Article editing time: 483 days


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