Whipple's disease

La Revue de médecine interne
Xavier Puéchal

Abstract

Whipple's disease is a chronic, multisystemic, curable, bacterial infection that usually affects middle-aged men. It has a wide range of clinical manifestations. In the historical presentation, weight loss and diarrhoea are the most common symptoms and are preceded in three-quarters of cases by arthritis for a mean of six years. Long-term, unexplained, seronegative oligoarthritis or polyarthritis of large joints with a palindromic or relapsing course is typical. In most patients, periodic acid-Schiff staining of proximal small bowel biopsy specimens reveals inclusions within the macrophages, corresponding to bacterial structures. However, patients may have no gastrointestinal symptoms, negative jejunum biopsy results and even negative PCR tests. Even in the absence of gastrointestinal symptoms, Whipple's disease should be considered in case of negative blood culture endocarditis, unexplained central neurological manifestations or unexplained arthritis. Identification of the causative bacterium, Tropheryma whipplei, has led to the development of PCR as a diagnostic tool, particularly useful in patients in the early stages of the disease or with atypical disease. The recent cultivation of T. whipplei and the complete sequencing o...Continue Reading

References

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Citations

Sep 4, 2012·La Revue de médecine interne·M VayssadeM Soubrier
Mar 23, 2011·La Revue de médecine interne·C WintenbergerC Massot
Aug 30, 2011·La Revue de médecine interne·N GirszynP Kaminsky
Jan 29, 2011·Annales de cardiologie et d'angéiologie·A Brondex, Y Jobic
Nov 26, 2010·La Revue de médecine interne·P Parize, J-L Mainardi
Mar 10, 2009·La Revue de médecine interne·Y BenhamouH Lévesque
Jan 18, 2015·La Revue de médecine interne·T Zenone
Oct 20, 2018·Movement Disorders : Official Journal of the Movement Disorder Society·Julien F BallyAnthony E Lang
Mar 13, 2010·Southern Medical Journal·Christos St BasagiannisSpiros D Ladas

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