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[Whipple disease]

D Gaist1, K Ladefoged

  • 1Medicinsk afdeling, Roskilde Amts Sygehus i Køge.

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|October 18, 1993
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Summary
This summary is machine-generated.

This case report details Whipple's disease (WD) presenting with joint pain, weight loss, and fever. Successful treatment involved antibiotics, though elevated alkaline phosphatase persisted.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Rheumatology

Background:

  • Whipple's disease (WD) is a rare, chronic, systemic bacterial infection caused by Tropheryma whipplei.
  • It can affect multiple organ systems, including the gastrointestinal tract, joints, central nervous system, and heart.

Observation:

  • A patient presented with migrating arthralgia, followed by weight loss, malaise, fever, and abdominal discomfort.
  • Physical examination revealed malnutrition, anemia, pyrexia, and mild abdominal distention.
  • CT scans showed retroperitoneal lymphadenopathy, and gastroduodenoscopy revealed characteristic white plaques and erosions in the duodenum.

Findings:

  • Duodenal biopsies confirmed pathological changes consistent with Whipple's disease.
  • The patient was treated with parenteral penicillin followed by a year of sulfamethoxazole and trimethoprim.
  • Treatment led to a satisfactory clinical response.

Implications:

  • This case highlights the diverse initial presentation of Whipple's disease, emphasizing the importance of considering it in patients with unexplained arthralgia and gastrointestinal symptoms.
  • The successful antibiotic regimen underscores current treatment protocols for WD.
  • Persistent elevation of serum alkaline phosphatase post-treatment warrants further investigation.