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Published on: February 27, 2015

Bone marrow involvement in Whipple's disease: rarely reported, but really rare?

R Walter1, S P Bachmann, A Schaffner

  • 1Department of Medicine, Medical Clinic B, University Hospital, Rämistrasse 100, CH-8091 Zurich, Switzerland. roland.walter@dim.usz.ch

British Journal of Haematology
|March 22, 2001
PubMed

Insights

Whipple's disease, caused by Tropheryma whippelii, often affects multiple organs. Bone marrow involvement in Whipple's disease is frequently overlooked but can be diagnosed via PAS-positive macrophages.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Hematology

Background:

  • Whipple's disease is a rare systemic infection caused by Tropheryma whippelii.
  • The disease typically affects the small intestine but can involve multiple organ systems.

Observation:

  • This report details a case of Whipple's disease presenting with lymphoma-like symptoms and bone marrow involvement.
  • Bone marrow involvement in Whipple's disease is often underdiagnosed.

Findings:

  • Diastase-resistant periodic acid-Schiff (PAS)-positive macrophages in bone marrow can be a diagnostic clue.
  • Diagnosis can be supported by PAS histology of upper endoscopic biopsies, PCR, or electron microscopy.

Implications:

  • Recognizing bone marrow involvement is crucial for accurate Whipple's disease diagnosis.
  • This finding may prompt earlier and more effective treatment strategies for affected patients.

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