Scintigraphic History of Arthritis in Whipple’s Disease

We describe a case of Whipple’s disease with pulmonary hypertension in a 72-year-old woman in whom the pulmonary hypertension resolved completely after antibiotic therapy. She was admitted to study with a 2-months history of weight loss, diarrhoea, abdominal pain, asthenia, inappetence, and fever. She did not have dyspnoea or respiratory symptoms. A casual echocardiogram showed a pulmonary artery systolic pressure of 95 mmHg. Forty days after starting antibiotic therapy, an echocardiogram showed a complete normalisation of right ventricular involvement. Whipple’s disease is a rare and multisystemic disorder in which pulmonary involvement is not a well-known finding. Although Whipple’s disease is not generally considered as a possible cause of pulmonary hypertension, such awareness is important because it may be potentially resolved with antibiotic therapy.

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Granulomatous lung disease and immune reconstitution inflammatory syndrome in Whipple’s disease

BMJ Case Reports ◽

10.1136/bcr-2021-243633 ◽

2021 ◽

Vol 14 (6) ◽

pp. e243633

Author(s):

Patrick Hofmann ◽

Nina Durisch ◽

Claudia Buetikofer ◽

Birgit Maria Helmchen

Keyword(s):

Immune Reconstitution Inflammatory Syndrome ◽

Immune Reconstitution ◽

Epithelioid Cell ◽

Intestinal Biopsy ◽

Whipple’S Disease ◽

Whipple's Disease ◽

Granulomatous Lung Disease ◽

History Of ◽

Inflammatory Syndrome ◽

Recurrent Pleural Effusion

We present the case of a 70-year-old woman with a history of seronegative arthritis, recurrent pleural effusion and weight loss. A prior lung biopsy had revealed non-caseating epithelioid cell granulomas without evidence for microbial organisms on special stains. Intestinal biopsy findings where suspicious for Whipple’s disease, which was confirmed by PCR testing, both on the intestinal and retrospectively on the lung tissue. Treatment with ceftriaxone resulted in clinical deterioration with fever, arthritis and recurrent pleuritis consistent with immune reconstitution inflammatory syndrome. Dose increase of glucocorticoids and therapy rotation to doxycycline and hydroxychloroquine resulted in rapid clinical improvement.

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Whipple’s Disease: A Rare Cause of Diarreha

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc.06.06.02 ◽

2021 ◽

Vol 6 (6) ◽

Keyword(s):

Weight Loss ◽

Fecal Incontinence ◽

Physical Examination ◽

Obese Patient ◽

Personal History ◽

Whipple’S Disease ◽

Whipple's Disease ◽

Associated Symptoms ◽

History Of

We describe the case of a 55-year-old man, with a personal history of dyslipidemia, hyperuricemia and obesity, on atorvastatin and allopurinol. He went to a Gastroenterology consultation due to diarrhea with several years of evolution, from 3 daily spills, worsening in the last weeks to 10-12 daily spills, of liquid feces, without blood, mucus or pus, accompanied by defecatory urgency and fecal incontinence. He denied other associated symptoms, such as nausea, vomiting, weight loss or fever. Physical examination showed an obese patient, colored and hydrated skin and mucosa, without palpable adenomegalies, abdomen without changes.

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Scanning Electron Microscopy of Human Jejunum in Whipple's Disease

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100079279 ◽

1977 ◽

Vol 35 ◽

pp. 354-355

Author(s):

John H. L. Watson ◽

C. N. Sun

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Basement Membrane ◽

Lamina Propria ◽

Brush Border ◽

Whipple’S Disease ◽

Whipple's Disease ◽

Biopsy Specimens ◽

Brush Borders ◽

Scanning Electron

That the etiology of Whipple's disease could be bacterial was first suggested from electron micrographs in 1960. Evidence for binary fission of the bacteria, their phagocytosis by histiocytes in the lamina propria, their occurrence between and within the cells of the epithelium and on the brush border of the lumen were reported later. Scanning electron microscopy has been applied by us in an attempt to confirm the earlier observations by the new technique and to describe the bacterium further. Both transmission and scanning electron microscopy have been used concurrently to study the same biopsy specimens, and transmission observations have been used to confirm those made by scanning.The locations of the brush borders, the columnar epithelial cells, the basement membrane and the lamina propria beneath it were each easily identified by scanning electron microscopy. The lamina propria was completely filled with the wiener-shaped bacteria, Fig. 1.

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