[Whipple's disease. Do we think of it enough?].

Abstract:

UNLABELLED:Whipple's disease is a chronic, systemic, relapsing bacterial illness, which is always fatal without treatment, and means a diagnostic challenge for both clinicians and pathologists. It occurs in Caucasian, white, middle-aged men in 80 % of the cases. CASE REPORT:The authors present three cases, and review the etiology, clinical features, presumed pathomechanism and the possibilities of treatment. CONCLUSION:Several immune-mechanisms have been discussed in the background of Whipple's disease, but their primary or secondary role is yet undetermined. First of all, this is a gastrointestinal disease; however, extraintestinal symptoms may be present many years before the final diagnosis. The histological hallmark for the diagnosis is the presence of numerous macrophages in the duodenal mucosa showing periodic acid-Schiff (PAS)-positive inclusions, and the polymerase chain reaction. The choice of antibiotics and the length of the treatment is empiric, but in most cases there is an immediate response to therapy. Relapses are common, especially the involvements of central nervous system.

journal_name

Orv Hetil

journal_title

Orvosi hetilap

authors

Fischer T,Tiboly M,Tóth P,Szenes M,Völgyi Z,Bali O,Gasztonyi B

doi

10.1556/OH.2009.28668

subject

Has Abstract

pub_date

2009-07-12 00:00:00

pages

1313-9

issue

28

eissn

0030-6002

issn

1788-6120

pii

D8860364P7H31241

journal_volume

150

pub_type

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