惠普尔病:慢性腹患者的诊断挑战
Elisa Veigas1, João Lança Pereira1, Marta Marques2
1Internal Medicine, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu, PRT.
Cureus
|February 6, 2026
概括
惠普尔病是一种罕见的Tropheryma whipplei感染,由于模糊的症状,经常被忽视. 早期诊断和抗生素治疗对于管理这种多系统性疾病至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
- 类风湿病学 类风湿病学
背景情况:
- 惠普尔病是一种罕见的多系统性感染,由Tropheryma whipplei引起.
- 由于非特异性和可变的症状,它经常被诊断不足,导致治疗的潜在延迟.
- 延迟诊断可能导致广泛的器官干扰和严重的健康后果.
研究的目的:
- 突出诊断挑战和早期识别惠普尔病的重要性.
- 介绍一个案例研究,说明诊断过程和惠普尔病的成功治疗.
- 强调重复内镜评估和及时抗生素治疗在实现有利结果中的作用.
主要方法:
- 一个74岁的男性患者的病例报告显示,他患有慢性腹,体重减轻和疲劳.
- 包括成像和内镜在内的初步调查没有显著的结果.
- 重复内镜检查显示了十二指甲状腺斑块,组织学通过定期酸-Schiff和CD68染色证实了惠普尔病.
主要成果:
- 该患者接受了为期两周的 ceftriaxone 疗程,随后接受了一年多西环素和氧化,并实现了快速的临床缓解.
- 由于持续的组织学发现,抗生素治疗被延长了额外的1.5年,用trimethoprim-sulfamethoxazole和doxycycline.
- 在随访期间,患者仍然无症状,这表明治疗和疾病管理取得了成功.
结论:
- 怀普尔病的诊断可能是具有挑战性的,因为症状与其他胃肠道和类风湿病症重叠.
- 保持高的怀疑指数和使用重复内镜评估对于及时诊断至关重要.
- 及时和适当的抗生素治疗与有利的临床结果有关,即使在复杂或长期的病例中也是如此.
相关概念视频
Chronic Bowel Disorders: Introduction
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Inflammatory Bowel Disease II: Crohn's Disease
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Inflammatory Bowel Disease I: Introduction
Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease III: Crohn's Disease
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Inflammatory Bowel Disease IV: Clinical Manifestations
Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...


