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Updated: Jul 9, 2026
Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Premature ovarian failure in suspected Whipple's disease
Stefano Ferrari1, Francesca Di Puppo, Paola Persico
1Ob-Gyn Department, Vita-Salute University, H San Raffaele, Milan, Italy. stefano.ferrari@fastwebnet.it
Introduction:
Whipple's disease is a relapsing systemic infectious disease probably caused by the Gram-positive bacillus Tropheryma whippelii. The diagnosis can be established based on the characteristic histopathological features found in the affected organ (foamy macrophages with a coarsely granular cytoplasm, which stains with PAS, and by means of polymerase chain reaction (PCR) technology).
Case Report:
We report a case of a 23-year-old woman affected by suspected Whipple's disease. She presented encephalopathy and neuropathy with inveterate hyperpyrexia and alteration of the hypothalamic-pituitary-ovary axe. She was amenorrheic because of an hypergonadotropic hypogonadism.
Discussion:
This hypogonadism is possibly due to follicular depletion caused by inveterate hyperpyrexia or T. whipplii localization.
Insights
Whipple's disease, a rare infection, can cause neurological and endocrine issues. In a young woman, it led to amenorrhea due to hypergonadotropic hypogonadism, possibly from prolonged fever or bacterial localization.
Area of Science:
- Infectious Diseases
- Endocrinology
- Neurology
Background:
- Whipple's disease is a systemic infection caused by Tropheryma whippelii.
- Diagnosis relies on histopathology (PAS-positive foamy macrophages) and PCR.
- The disease can affect multiple organ systems.
Observation:
- A 23-year-old woman presented with suspected Whipple's disease.
- Symptoms included encephalopathy, neuropathy, persistent fever, and hypothalamic-pituitary-ovary axis dysfunction.
- She experienced amenorrhea secondary to hypergonadotropic hypogonadism.
Findings:
- The patient exhibited signs of severe systemic infection.
- Endocrine evaluation revealed hypergonadotropic hypogonadism.
- The case highlights potential reproductive complications of Whipple's disease.
Implications:
- Whipple's disease can manifest with significant endocrine disturbances, including hypogonadism.
- Persistent hyperpyrexia or direct Tropheryma whippelii infection may cause follicular depletion.
- Early diagnosis and treatment are crucial to prevent long-term complications.
