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Peripheral neuropathy in Whipples disease: a case report
1Department of Neurology, Thomayer Teaching Hospital, Prague, Czech Republic.
Ceskoslovenska Patologie
|June 22, 2012
Summary
Whipples disease, a rare infection, can cause axonal peripheral neuropathy without typical gastrointestinal symptoms. Prompt antibiotic treatment resolved neurological issues, highlighting nerve biopsy value.
Area of Science:
- Infectious Diseases
- Neurology
- Pathology
Background:
- Whipples disease is a chronic, multisystem inflammatory condition primarily affecting the gastrointestinal tract.
- Neurological manifestations are known but peripheral neuropathy is rarely documented.
- Tropheryma whipplei is the causative bacterium.
Observation:
- A case of Whipples disease presented with axonal peripheral neuropathy as the primary symptom.
- Gastrointestinal involvement was notably absent in this patient.
- Diagnosis was confirmed via sural nerve biopsy and PCR analysis.
Findings:
- The patient's peripheral neuropathy resolved completely with antibiotic therapy.
- Two years post-infection, the patient developed Parkinson's disease, considered unrelated.
- This case demonstrates Tropheryma whipplei's ability to cause neuropathy.
Implications:
- Peripheral nerve biopsy is valuable for diagnosing unexplained axonal neuropathies.
- This case expands the known clinical spectrum of Whipples disease.
- Highlights the importance of considering Tropheryma whipplei in atypical presentations.
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