Whipple's disease: report of cases diagnosed in our hospital.
We present here a retrospective study of nine patients diagnosed with Whipple's disease (WD) in our hospital. This report em-phasises clinical presentation, diagnostic methods, treatment and response to treatment. In our study, the disease was more frequent in males, and the most frequent presenting symptoms were arthralgia, diarrhoea and weight loss. Since the intestine is almost always affected, oral endoscopy is a useful technique for the diagnosis of WD because it shows the typical miliary pattern and aids in obtaining biopsies to show the presence of PAS-positive macrophages (a suggestive though not diagnostic finding), to show bacilli using electron microscopy, or to detect genetic material using PCR. Our patients responded well to treatment. The most frequently used antibiotic was oral trimethoprim-sulfamethoxazole for at least one year. Treatment with penicillin G and IM streptomycin for 14 days was reserved for severe cases or cases that responded poorly to treatment.
Reyes Martínez
C
C
Servicio de Aparato Digestivo y Microbiología. Hospital Virgen del Rocío. Sevilla. Spain.
Cordero Fernández
C
C
Torronteras Santiago
R
R
Reina Campos
F R
FR
Márquez Galán
J L
JL
Sánchez Agüera
M
M
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D004724:Endoscopy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D013307:Streptomycin / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use; D008061:Whipple Disease / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D010406:Penicillins; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D010400:Penicillin G; D013307:Streptomycin