Whipple's disease - A typical endoscopic finding of a rare disease

Rev Esp Enferm Dig. 2024 Mar;116(3):157-158. doi: 10.17235/reed.2022.9338/2022.

Abstract

A 49-year-old female presented with a 5-month course of diarrhoea, nocturn abdominal pain, asthenia, and weight loss of 30% of her body mass in three months. The patient had also a four-year medical history of bilateral mechanic gonalgy and arthralgias of the metacarpophalangeal and interphalangeal joints, despite treatment with prednisolone. On examination the patient had hyperpigmentation of the face and thorax, low-grade fever, and a BMI of 15,8 Kg/m2. Diarrhoea was documented with watery stools seven times per day despite loperamide, brownish, with no visible blood or mucous. Since the upper GI endoscopy and colonoscopy had no macroscopic abnormalities, the patient underwent a capsule endoscopy, which revealed continuous mucosal lesion with lymphangiectasia, oedema, villous atrophy and areas of denudation with hematinic punctate from the duodenum to the ileum. Diagnosis of Whipple's Disease was made with typical histology findings in duodenum material and a positive PCR for Tropheryma whipplei.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Anti-Bacterial Agents
  • Capsule Endoscopy*
  • Diarrhea
  • Female
  • Humans
  • Middle Aged
  • Rare Diseases
  • Tropheryma
  • Whipple Disease* / complications
  • Whipple Disease* / diagnosis
  • Whipple Disease* / drug therapy

Substances

  • Anti-Bacterial Agents