怀普尔病的病例与同时发生的食道候群病
Ryan Choi1, Alexander Pazevic1, Kevin Pak2
1Department of Internal Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA.
Military medicine
|August 4, 2023
概括
惠普尔病 (WD) 是一种罕见的细菌感染,可以导致免疫抑制和各种症状. 早期诊断和治疗至关重要,但Tropheryma whipplei很难根除,需要长期监测.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 惠普尔病 (WD) 是一种罕见的系统性感染,由Tropheryma whipplei引起.
- WD可能导致免疫抑制,在多个器官系统中表现为多样化和看似无关的症状.
- 根除T. whipplei可能具有挑战性,增加了复发的风险.
研究的目的:
- 为了呈现Whipple病的病例与同时发生的食道候群病.
- 要突出诊断挑战和治疗结果为WD.
- 讨论与WD相关的免疫抑制对复发率的影响.
主要方法:
- 一个36岁男性的案例研究,患有不明原因的腹,关节痛和体重减轻.
- 诊断程序包括T. whipplei.的食管胃管腺镜,结肠镜和聚合酶链反应 (PCR).
- 治疗包括抗生素治疗WD,食道角膜炎和H. pylori感染,随后进行长期监测.
主要成果:
- 患者出现了水性腹,迁移性关节炎和体重减轻,最初未被诊断出来.
- 内镜检查显示食道候群病,H. pylori,十二指肠/肠泡性巨细胞通过PCR对T. whipplei呈阳性.
- 成功治疗导致症状缓解,但在后续内镜检查中发现了持续的泡性巨细胞.
结论:
- 在WD中同时发生的食道候群症表明,由于T辅助细胞1活动受损,导致相对免疫抑制的状态.
- 这种免疫抑制可能有助于在惠普尔病中观察到的高复发率.
- 对于WD患者,建议重新评估复发症状的低门和定义的长期监测策略.
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