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Whipple's disease can mimic chronic AIDS enteropathy
G M Maliha1, K S Hepps, D M Maia
1Department of Medicine, Baylor College of Medicine, Houston, Texas.
The American Journal of Gastroenterology
|January 1, 1991
Summary
Mycobacterium avium-intracellulare (MAI) infection in acquired immune deficiency syndrome (AIDS) can mimic Whipple's disease. This case highlights that Whipple's disease can also present with opportunistic infections, mimicking AIDS.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Mycobacterium avium-intracellulare (MAI) infection in acquired immune deficiency syndrome (AIDS) shares light microscopic intestinal pathology with Whipple's disease.
- Whipple's disease is a rare systemic infection typically affecting the small intestine.
Observation:
- A 52-year-old male presented with AIDS-like symptoms: diarrhea, weight loss, oral thrush, and intestinal cryptosporidiosis.
- Intestinal biopsy revealed features consistent with either MAI or Whipple's disease.
- Electron microscopy definitively identified the Whipple bacillus, with no evidence of human immunodeficiency virus (HIV) infection.
Findings:
- This case is the first to report opportunistic infections complicating Whipple's disease.
- The patient exhibited clinical manifestations suggestive of AIDS but tested negative for HIV.
Implications:
- Highlights the diagnostic challenge: AIDS can mimic Whipple's disease, and vice versa.
- Underscores the importance of advanced diagnostic techniques like electron microscopy when light microscopy is inconclusive.
- Suggests that immune dysregulation in Whipple's disease may predispose to opportunistic infections.