INTESTINE Vol.21 No.6(2-10)

Theme Reviewing inflammatory diseases of small bowel
Title Clinicopathological features of Whipple's disease
Publish Date 2017/11
Author Tomohiro Nagasue Division of Gastroenterology, Matsuyama Red Cross Hospital / Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Author Koichi Kurahara Division of Gastroenterology, Matsuyama Red Cross Hospital
Author Keisuke Kawasaki Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
Author Hiroki Yaita Division of Gastroenterology, Matsuyama Red Cross Hospital
Author Yumi Oshiro Department of Pathology, Matsuyama Red Cross Hospital
Author Motohiro Esaki Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
[ Summary ] Whipple's disease (WD) is a very rare infectious disease caused by Tropheryma whipplei (T. whipplei). This disease exhibits a variety of symptoms such as heart, joint and central nervous symptoms in addition to gastrointestinal symptoms such as abdominal pain and diarrhea. Predilection sites in the gastrointestinal tract range from the duodenum to the jejunum. Endoscopic findings are characterized by diffuse white villi.
The pathological features of WD are accrual of periodic acid Schiff (PAS) stained foamy macrophages in the lamina propria as observed in duodenal biopsies. A definitive diagnosis of WD is made by detection of T. whipplei with PCR or electron microscopy. Treatment, commonly consists of administration of sulfamethoxazole/trimethoprim for approximately one year after a two week administration of ceftriaxone.
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