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Vitrectomy and Whipple's disease
Archives of Ophthalmology (Chicago, Ill. : 1960)
|June 1, 1984
Abstract:
We diagnosed Whipple's disease from the vitreous aspirate of two patients who underwent vitrectomies . In one case, the vitrectomy specimen would have indicated the diagnosis three years before the jejunal biopsy was performed had the appropriate PAS stain been used. In the second case, the PAS-positive macrophages were identified at the time of surgery.
Insights
Diagnosing Whipple's disease is possible using vitreous aspirate from vitrectomies. Early diagnosis of Whipple's disease can be achieved with appropriate staining methods, potentially years sooner than traditional methods.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Gastroenterology
Background:
- Whipple's disease is a rare bacterial infection that can affect multiple organ systems.
- Diagnosis typically relies on small intestine biopsy, which can be invasive and delayed.
- Ocular involvement is a known, though less common, manifestation.
Observation:
- Two patients with Whipple's disease were diagnosed via vitreous aspirate analysis following vitrectomy surgery.
- In one patient, the diagnosis could have been made three years earlier if Periodic Acid-Schiff (PAS) staining had been utilized on the vitrectomy specimen.
- In the second patient, PAS-positive macrophages, indicative of Whipple's disease, were identified during the surgical procedure.
Findings:
- Vitreous aspirate from vitrectomy is a viable diagnostic sample for Whipple's disease.
- The use of PAS staining on ocular specimens can significantly expedite the diagnosis of Whipple's disease.
- Timely identification of PAS-positive macrophages in ocular samples aids in early diagnosis.
Implications:
- This suggests a potential for earlier diagnosis of Whipple's disease through ophthalmological examination and vitreous analysis.
- Ophthalmologists may play a crucial role in the early detection of systemic Whipple's disease.
- Incorporating specific stains like PAS in ocular pathology could improve diagnostic timelines and patient outcomes for Whipple's disease.