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Updated: Nov 11, 2025

Skin Biopsy for Diagnosing Discoid Lupus Erythematosus
Published on: June 10, 2025
Whipple's disease diagnosed in a patient with suspected sarcoidosis
David Totschnig1, Tamara Seitz1, Alexander Zoufaly1
1Department of Medicine IV, Kaiser Franz Josef Hospital, Vienna, Austria.
Abstract:
This paper presents a case of a 51-year-old patient with chronic diarrhea, weight loss, polyarthralgia, and diffuse lymphadenopathy. Laboratory work-up showed anemia, leukocytosis and thrombocytosis, and increased C-reactive protein (CRP). Due to an inconspicuous differential leukocyte count and lymph node biopsy findings showing granulomatous lymphadenopathy, sarcoidosis was initially suspected. Colonoscopy found no abnormalities and duodenal biopsies showed negative Periodic acid-Schiff stains. However, PCR testing on these biopsies revealed Tropheryma whipplei DNA. Further PCR testing of urine and cerebrospinal fluid also revealed T. whipplei DNA. The patient was treated with ceftriaxone for 2 weeks followed by trimethoprim for a year. A rapid improvement of his symptoms was seen.
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