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CASE REPORT

Whipple’s Disease: Case Report and Review of the Literature

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Vincenzo De Francesco1, Fabrizio Corsi2, Antonio Pennella2, Annamaria Bellesia1, Giulia Fiorini3, Dino Vaira3, Angelo Zullo4
1) Section of Gastroenterology, Department of Medical Sciences, Foggia;
2) Department of Pathology, University of Foggia, Foggia;.
3) Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna;
4) Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.273.fra

ABSTRACT

Whipple’s disease (WD) is known as an infrequent, systemic, chronic infection caused by the actinomycete Tropherima whipplei (T. whipplei). The disease is frequently characterized by a long prodromal and protean extra-intestinal phase, which often causes misdiagnosis and inappropriate treatments. Herein, we describe the case a 62-year-old man with a histological diagnosis of WD established when oral steroid treatment was started due to rheumatic manifestations, triggering intestinal symptoms. Systematic review of the literature was performed to include studies where WD was eventually diagnosed on duodenal biopsies. Three patients’ subgroups were identified according to the clinical presentation.

Key words: Whipple’s disease − Tropherima whipplei − endoscopy − gastrointestinal tract.

Abbreviations: NSAIDs: nonsteroidal anti-inflammatory drugs; PAS: periodic acid Schiff; T. whipplei: Tropherima whipplei; WD: Whipple’s disease.