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Gadolinium-enhanced MRI in cerebral Whipple's disease
E Erdem1, R Carlier, A Delvalle
1Department of Neuroradiology, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Neuroradiology
|January 1, 1993
Abstract:
Confusion developed in a 44-year-old man, who had diarrhoea and weight loss for three months. Jejunal biopsy showed infiltration by PAS-positive macrophages, indicating Whipple's disease. Cranial MRI disclosed multiple lesions mainly in the white matter and grey-white matter junction better demonstrated after gadolinium injection.
Insights
Whipple's disease, a rare bacterial infection, can cause neurological symptoms like confusion. Early diagnosis through jejunal biopsy and MRI is crucial for effective treatment.
Area of Science:
- Neurology
- Gastroenterology
- Infectious Diseases
Background:
- Whipple's disease is a rare systemic infection caused by Tropheryma whipplei.
- It commonly affects the gastrointestinal tract but can manifest with diverse neurological symptoms.
Observation:
- A 44-year-old male presented with confusion, diarrhea, and weight loss over three months.
- Jejunal biopsy revealed characteristic PAS-positive macrophages, confirming Whipple's disease.
Findings:
- Cranial MRI demonstrated multiple white matter lesions, particularly at the grey-white matter junction.
- Gadolinium enhancement highlighted the extent of these neurological lesions.
Implications:
- This case underscores the importance of considering Whipple's disease in patients with unexplained neurological and gastrointestinal symptoms.
- Prompt diagnosis and treatment are essential to prevent severe neurological complications.