scholarly journals Whipple’s Disease Affecting Ileal Peyer’s Patches: The First Case Report

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sabah Sid’Amar ◽  
Giacomo Puppa
Keyword(s):  
Lymphoid Tissue ◽  
Diagnostic Yield ◽  
Clinical Investigation ◽  
Periodic Acid ◽  
Disease Diagnosis ◽  
Peyer's Patches ◽  
Peyer’S Patches ◽  
Whipple’S Disease ◽  
Whipple's Disease ◽  
First Case

Whipple’s disease is a rare chronic systemic bacterial infectious disease which can affect multiple organs, with a wide clinical spectrum encompassing many symptoms presenting in various forms and combinations. In the cases where the gastrointestinal tract is implicated, the more frequent localizations involve the small bowel, especially the duodenum. A case of a 67-year-old man who underwent clinical investigation after presenting with a progressive weight loss and showing a hypercapting right paracoeliac adenopathy at PET-CT scan is reported herein. A gastroscopy and a colonoscopy were done. The biopsies of the endoscopically normal ileal mucosa encompassed some submucosal Peyer’s patches. Histological examination of this lymphoid tissue revealed several foamy macrophages which turned out positive on periodic acid-Schiff special staining. Polymerase chain reaction of the microdissected lymph follicles allowed for confirming Whipple’s disease diagnosis. A targeted antibiotic treatment administrated to the patient led to a rapid clinical improvement. This finding of a previously unreported localization of infected macrophages in Whipple’s disease suggests that sampling the organized mucosal-submucosal lymphoid tissue may increase the diagnostic yield in endoscopic biopsies.

Histochemical Studies on Post Natal Development of Gut Associated Lymphoid Tissue (GALT) of Intestine of Pati Duck (Anas platyrhynchos domesticus) of Assam

2021 ◽  
Author(s):  
A. Deka ◽  
M. Talukdar ◽  
D.J. Talukdar
Keyword(s):  
Phosphatase Activity ◽  
Lymphoid Tissue ◽  
Correct Diagnosis ◽  
Peyer's Patches ◽  
Peyer’S Patches ◽  
Moderate Activity ◽  
Strong Reaction ◽  
Strong Activity ◽  
Lymphoid Follicles ◽  
Lymphoid Nodules

Background: The Pati duck constitutes a major indigenous duck variety in the state of Assam. The study of the gut associated lymphoid tissue (GALT) of Pati duck of Assam is of great value in regard to normal academic and bio-medical research aspects. It is also pre-requisite for correct diagnosis and evaluating the treatment of certain diseases like duck virus enteritis, duck cholera, aflatoxicosis, botulism etc, caused by different types of pathogens, food poisoning and food allergy. Methods: The study was conducted on Pati duck of Assam in where 45 numbers of ducks were selected by irrespective of sex at different stages of development. The birds were divided into five groups depending on its age viz., 1st week, 4th week, 16th week, 24th week and 42nd weeks old. The pieces of gut having lymphoid tissue or Peyer’s patches were collected immediately after slaughter. Samples were made cryosections (-20oC) at 10µm in thickness and were temporally stored at (-22oC). The histochemical staining was done after that. Result: The acid phosphatase activity was weak in the lymphoid follicles of 1st and 4th week of age of Pati duck, while its activity was moderate in 16th, 24th and 42th week of age.The alkaline phosphatase activity was moderate reaction in the lymphoid follicles of 1st and 4th week of age of Pati duck, while its activity was intense in 16th, 24th and 42th week of age of duck. The lymphoid follicles of both Peyer’s patches and solitary lymphoid nodules were showed moderate activity for adenosine tri-phosphatase activity in 1st and 4th week old Pati duck and strong activity in 16th, 24th and 42th week of age of Pati duck, respectively. The lymphoid nodules of intestine showed strong reaction for non-specific esterase activity in all the age groups of Pati duck.

Functional zones of Peyer’s patch (PPs) in rabbits’ caecum

2021 ◽  
Vol 9 (2) ◽  
pp. 82-86
Author(s):  
M. O. Nikitina ◽  
M. V. Kravtsova ◽  
A. A. Bohomaz
Keyword(s):  
Germinal Center ◽  
Lymphoid Tissue ◽  
Experimental Period ◽  
Vermiform Appendix ◽  
Mean Value ◽  
Germinal Centers ◽  
Peyer's Patches ◽  
Peyer’S Patches ◽  
Mantle Zone ◽  
Lymphoid Nodules

A feature of rabbit gut-associated lymphoid tissue is that its structure is more developed than in other animal species. In rabbits it is composed of sacculus rotundus, vermiform appendix and Peyer’s patches. These immune formations contain an organized component of lymphoid tissue – lymphoid nodules (B-cell zone) and interfollicular region (T-cell). Secondary lymphoid nodules with germinal centers presented in them are formed due to antigen stimulation. The caecum of Hyplus rabbits at the age of 30 -, 60 - and 90-days was investigated. Each age group consisted of 5 rabbits. Experimental rabbits are clinically healthy, unvaccinated and untreated against ecto- and endoparasites. Peyer’s patches of the caecum were selected for the study and fixed in 10% of formalin. Subsequently, the specimens stained with hematoxylin-eosin were prepared from the obtained samples. On the 30th day of life, Peyer’s patches in the cecum were detected by gross examination. On the histological level, they had formed interfollicular region and lymphoid nodules. In turn, lymphoid nodules were divided into primary and secondary ones. A well-defined mantle zone and germinal centers were observed in the secondary lymphoid nodules. The regularities of their area indicators increase (mean value, median and interquartile range (IQR)) and their correlation were studied. The most intensive growth of the mantle area and the germinal center was observed from the 30th to the 60th day. The relative area of the mantle zone and the germinal center as part of the secondary lymphoid nodule was determined. Its value did not change during the experimental period.

scholarly journals Whipple's disease: rare disorder and late diagnosis

2012 ◽  
Vol 54 (5) ◽  
pp. 293-297 ◽  
Author(s):  
Viviane Plasse Renon ◽  
Marcelo Campos Appel-da-Silva ◽  
Rafael Bergesch D'Incao ◽  
Rodrigo Mayer Lul ◽  
Luciana Schmidt Kirschnick ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Disease Diagnosis ◽  
Endoscopic Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Whipple’S Disease ◽  
Whipple's Disease ◽  
Polymerase Chain ◽  
One Year ◽  
Infectious Disorder

Whipple's disease is a rare systemic infectious disorder caused by the bacterium Tropheryma whipplei. We report the case of a 61-year-old male patient who presented to emergency room complaining of asthenia, arthralgia, anorexia, articular complaints intermittent diarrhea, and a 10-kg weight loss in one year. Laboratory tests showed the following results: Hb = 7.5 g/dL, albumin = 2.5 mg/dL, weight = 50.3 kg (BMI 17.4 kg/m²). Upper gastrointestinal endoscopy revealed areas of focal enanthema in the duodenum. An endoscopic biopsy was suggestive of Whipple's disease. Diagnosis was confirmed based on a positive serum polymerase chain reaction. Treatment was initiated with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole. After one year of treatment, the patient was asymptomatic, with Hb = 13.5 g/dL, serum albumin = 5.3 mg/dL, and weight = 70 kg (BMI 24.2 kg/m²). Whipple's disease should be considered a differential diagnosis in patients with prolonged constitutional and/or gastrointestinal symptoms. Appropriate antibiotic treatment improves the quality of life of patients.

scholarly journals Whipple's Disease and “Tropheryma whippelii”

2001 ◽  
Vol 14 (3) ◽  
pp. 561-583 ◽  
Author(s):  
Fabrizio Dutly ◽  
Martin Altwegg
Keyword(s):  
Bacterial Species ◽  
Periodic Acid ◽  
Clinical Manifestations ◽  
The Body ◽  
Rrna Gene ◽  
Low Grade ◽  
Whipple’S Disease ◽  
Major Step ◽  
Whipple's Disease ◽  
Initial Symptoms

SUMMARY Whipple's disease is a rare bacterial infection that may involve any organ system in the body. It occurs primarily in Caucasian males older than 40 years. The gastrointestinal tract is the most frequently involved organ, with manifestations such as abdominal pain, malabsorption syndrome with diarrhea, and weight loss. Other signs include low-grade fever, lymphadenopathy, skin hyperpigmentation, endocarditis, pleuritis, seronegative arthritis, uveitis, spondylodiscitis, and neurological manifestations, and these signs may occur in the absence of gastrointestinal manifestations. Due to the wide variability of manifestations, clinical diagnosis is very difficult and is often made only years or even decades after the initial symptoms have appeared. Trimethoprim-sulfamethoxazole for at least 1 year is usually considered adequate to eradicate the infection. The microbiological diagnosis of this insidious disease is rendered difficult by the virtual lack of culture and serodiagnostic methods. It is usually based on the demonstration of periodic acid-Schiff-positive particles in infected tissues and/or the presence of bacteria with an unusual trilaminar cell wall ultrastructure by electron microscopy. Recently, the Whipple bacteria have been characterized at the molecular level by amplification of their 16S rRNA gene(s). Phylogenetic analysis of these sequences revealed a new bacterial species related to the actinomycete branch which was named “Tropheryma whippelli.” Based on its unique 16S ribosomal DNA (rDNA) sequence, species-specific primers were selected for the detection of the organism in clinical specimens by PCR. This technique is currently used as one of the standard methods for establishing the diagnosis of Whipple's disease. Specific and broad-spectrum PCR amplifications mainly but not exclusively from extraintestinal specimens have significantly improved diagnosis, being more sensitive than histopathologic analysis. However, “T. whippelii” DNA has also been found in persons without clinical and histological evidence of Whipple's disease. It is unclear whether these patients are true asymptomatic carriers or whether differences in virulence exist among strains of “T. whippelii” that might account for the variable clinical manifestations. So far, six different “T. whippelii” subtypes have been found by analysis of their 16S-23S rDNA spacer region. Further studies of the pathogen “T. whippelii” as well as the host immune response are needed to fully understand this fascinating disease. The recent cultivation of the organisms is a promising major step in this direction.

scholarly journals Two Distinct Pathways of B-Cell Development in Peyer’s Patches

1995 ◽  
Vol 4 (4) ◽  
pp. 263-277 ◽  
Author(s):  
Philip J. Griebel ◽  
Birgit Kugelberg ◽  
Giorgio Ferrari
Keyword(s):  
Cell Proliferation ◽  
B Cells ◽  
B Cell ◽  
Lymphoid Tissue ◽  
Day Treatment ◽  
Cell Development ◽  
B Cell Development ◽  
Peyer's Patches ◽  
Peyer’S Patches ◽  
Dexamethasone Treatment

The developmental biology of sheep ileal and jejunal Peyer’s patches (PP) was investigated using corticosteroids to deplete immature B lymphocytes. During a 7-day treatment with dexamethasone, ileal PP follicular (iPf)B-cell proliferation was arrested and most iPfB-cells died. This resulted in follicular involution with the survival of mesenchymal cells. No iPfB-cell proliferation was detected in follicular remnants for 4 weeks postdexamethasone treatment, and during a subsequent 3-month period, there was limited iPfB-cell proliferation that resulted in a partial regeneration of follicles. Ileal PP involution was also associated with a severe B lymphopenia that persisted for over 14 weeks and was characterized by the survival of primarily isotype-switched and CD5+sIgM+B-cells in blood. In contrast, the size of jejunal PP follicles was reduced following dexamethasone treatment, but intrafollicular B-cell proliferation was not arrested. Furthermore, within 4 weeks, the jejunal PP follicles had recovered in size and cellularity and there was no disruption in IgA plasma-cell production. Thus, dexamethasone selectively depleted iPfB-cells and revealed that the ileal and jejunal PPs contain functionally distinct B-cell populations. The partial regeneration of the iPfB-cell population indicated that either an intrafollicular, corticosteroid-resistant B-stem cell existed or that ileal PP follicles can be repopulated by circulating B-cells. Finally, the association between ileal PP involution and the absence of circulating, CD5-B-cells confirmed that this lymphoid tissue provides an essential environment for conventional sIgM+B-cell development.

scholarly journals First case of Whipple’s disease successfully treated with tigecycline

GERMS ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 105-110
Author(s):  
Kalliopi Foteinogiannopoulou ◽  
Ioannis Mouzas ◽  
Maria Tzardi ◽  
Eleni Orfanoudaki ◽  
Eirini Theodoraki ◽  
...  
Keyword(s):  
Whipple’S Disease ◽  
Whipple's Disease ◽  
First Case

scholarly journals Characteristics of Intestinal Mucosa-associated Lymphoid Tissue in Experimental Trichinellosis in Rats

2020 ◽  
Vol 14 (3) ◽  
pp. 75-82
Author(s):  
O. B. Zhdanova ◽  
L. R. Mutoshvili ◽  
O. V. Rudneva ◽  
N. A. Makarova ◽  
L. A. Napisanova ◽  
...  
Keyword(s):  
Intestinal Mucosa ◽  
Lymphoid Tissue ◽  
Morphological Traits ◽  
Intestinal Wall ◽  
Peyer's Patches ◽  
Peyer’S Patches ◽  
And Control ◽  
Microscope Slides ◽  
Lymphoid Nodules ◽  
Experimental Group

The purpose of the research is studying intestinal mucosa-associated lymphadenoids (MALT) at trichinellosis. Materials and methods. The number of lymphoid nodules and Peyer’s patches was counted by grossing and microscope slides of intestinal specimen. We investigated their syntopy and morphological traits in Trichinella-infected and control animals. All morphological structures were described in accordance with anatomical, immunological and histological terminology. Results and discussion. The number of lymphoid nodules in the intestinal wall thickness increased by 1.63 times in the experimental group. The changes involved the syntopy of lymphoid tissue. There was an even distribution of lymphoid nodules being concentrated in some segments in the form of Peyer’s patches. The size of the grouped nodules in the experimental trichinellosis increased 1.31 times in the small intestine, and 1.26 times in the straight intestine. It was found that the MALTs were sensitive to the infection. Immunomorphological studies of the MALT should be considered in the development of safe complex drugs, immunostimulants or vaccines. Further, the condition of the MALT should be taken into account in the pathogenesis of trichinellosis along with classical methods such as parasitological (larvae or egg counts), immunological, immunohistochemical or other methods.

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