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Updated: May 21, 2026

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
Whipple's disease presenting with neurological symptoms in an immunosuppressed patient
Martijn Weisfelt1, Erik Oosterwerff, Mirjam Oosterwerff
1Department of Neurology, Kennemer Gasthuis, Haarlem, Netherlands. weisfelt@kg.nl
Abstract:
We report an unusual case of Whipple's disease, which remained undiagnosed for several years in a patient being treated with immunosuppressive therapy for many years. The patient presented with a purpuric rash, neurological symptoms, lymphadenopathy and gastrointestinal symptoms. The diagnosis was made by endoscopic biopsy of the duodenum with periodic acid Schiff staining, as well as PCR testing on blood and cerebrospinal fluid. The patient was successfully treated with intravenous ceftriaxone, followed by oral co-trimoxazole for 1 year.
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