title: Whipple's disease: the first Japanese case diagnosed by electron microscopy and polymerase chain reaction.
abstract: A 52-year-old man presented with diarrhea and 20 kg weight loss in one year. Enteroscopy showed diffuse yellow-white shaggy mucosa in the duodenum and jejunum. Biopsies of the duodenal mucosa revealed massive infiltration within the lamina propria by foamy macrophages strongly positive for periodic acid-Schiff stain. Electron microscopy demonstrated numerous bacilli within macrophages of the lamina propria. Tropheryma whipplei DNA was detected by polymerase chain reaction. The definitive diagnosis of Whipple's disease was made. Antibiotic therapy dramatically improved his clinical picture. This is the first Japanese case with Whipple's disease diagnosed by electron microscopy and polymerase chain reaction.
authors.affiliation: First Department of Internal Medicine, University of the Ryukyus, Nishihara, Okinawa.
authors.forename: Tatsuji
authors.initials: T
authors.lastname: Yogi
authors.forename: Akira
authors.initials: A
authors.lastname: Hokama
authors.forename: Fukunori
authors.initials: F
authors.lastname: Kinjo
authors.forename: Ryosaku
authors.initials: R
authors.lastname: Tomiyama
authors.forename: Michio
authors.initials: M
authors.lastname: Koide
authors.forename: Kazuto
authors.initials: K
authors.lastname: Kishimoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Makishi
authors.forename: Masaru
authors.initials: M
authors.lastname: Oshiro
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyagi
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kobashigawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Takaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakayama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
mesh_terms: D001707:Biopsy, Needle; D002443:Ceftriaxone / Q000008:administration & dosage*; D004269:DNA, Bacterial / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007262:Infusions, Intravenous; D007413:Intestinal Mucosa / Q000473:pathology / Q000648:ultrastructure; D007564:Japan; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D004269:DNA, Bacterial; D002443:Ceftriaxone