Whipple's disease. Case report.
The paper reports the clinical case of a 58 -year-old male patient admitted for diarrhea (6-7 stools/day, diffuse abdominal pain, borborygma, weight loss (20 kgs in two years), asthenia and fatigue. Physical examination evidenced a poor nutritional state (body mass index 19 kg/m2). The abdomen was slightly distended. Biological tests evidenced moderate/severe anemia, hypoproteinemia and hypoalbuminemia. Endoscopic examination evidenced oedematous duodenal mucosa with white-yellowish deposits. Histology (HE stain) revealed the presence of foamy cells and the PAS-staining of the duodenal mucosa evidenced PAS-positive macrophages and numerous intracellular bacilli. Penicillin therapy 2 x 1 million U/day for 14 days, followed by tetracycline 4 x 250 mg/day improved the clinical picture, the patient had only one stool per day and gained weight. After 7 months of treatment the general condition was good and the patient had gained 17 kgs, the duodenal mucosa was normal. HE staining did not evidence foamy cells and no PAS-positive macrophages could be found.
Andreica
Vasile
V
3rd Medical Clinic, University of Medicine and Pharmacy, Str. Croitorilor no. 19-21, 3400 Cluj-Napoca, Romania.
Pascu
Oliviu
O
Hagiu
Claudia
C
Paşca
Dana
D
Dumitra
Daniela
D
Dumitraşcu
Dan L
DL
Chiorean
Erica
E
Georoceanu
Anca
A
D015746:Abdominal Pain / Q000209:etiology; D003967:Diarrhea / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal; D005221:Fatigue; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D016896:Treatment Outcome; D015431:Weight Loss; D008061:Whipple Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*
D010406:Penicillins