title: [Persistent leucocytosis as initial manifestation of Whipple's disease and development of gastric cancer in the follow up].
abstract: We report the case of a 57 year old male with Whipple's disease. The patient was asymptomatic and an unexplained peripheral leucocytosis was found in a routine examination. It persisted as the only abnormality for one year and then he developed articular symptoms, diarrhoea and weight loss. The diagnosis was confirmed by duodenal biopsy five years later. The leucocyte count ranged between 14,000 and 22,000 leuc/mm3. Response to cotrimoxazole was favourable with disappearance of all signs and symptoms, including leucocytosis. In the last endoscopic control, eight years after initial manifestations, an intramucosal gastric adenocarcinoma was diagnosed.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Central de, Oviedo, 33006, España.
authors.forename: F
authors.initials: F
authors.lastname: Cadenas
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez-Lombraña
authors.forename: R
authors.initials: R
authors.lastname: Pérez
authors.forename: F J
authors.initials: FJ
authors.lastname: Lomo
authors.forename: B
authors.initials: B
authors.lastname: Madrigal Rubiales
authors.forename: S
authors.initials: S
authors.lastname: Vivas
authors.forename: L
authors.initials: L
authors.lastname: Rodrigo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001706:Biopsy; D004386:Duodenum / Q000473:pathology; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007964:Leukocytosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D008061:Whipple Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
vernacular_title: Leucocitosis persistente como debut de la enfermedad de Whipple con desarrollo de cáncer gástrico en el seguimiento.