Whipple's disease with muscle impairment.
A 67-year-old man presented with myalgia, muscle atrophy, and a history of seronegative polyarthritis. Blood tests showed inflammation but no hematologic or immunologic abnormalities. Muscle biopsy revealed no vasculitis or myositis but Tropheryma whipplei was detected by polymerase chain reaction in muscle, blood, and duodenum specimens; this was confirmed by immunohistochemistry. Ceftriaxone led to clinical improvement. Although rare, Whipple's disease should be considered in the differential diagnosis of diffuse myopathy.
Puget
Marie
M
Department of Internal Medicine, Centre Hospitalier Lyon-Sud, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France. mpuget@ch-valence.fr
Iwaz
Jean
J
Tristan
Anne
A
Streichenberger
Nathalie
N
D000192:Actinomycetales / Q000302:isolation & purification*; D000193:Actinomycetales Infections / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis / Q000097:blood; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000737:chemistry / Q000382:microbiology / Q000473:pathology; D020966:Muscular Disorders, Atrophic / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome; D008061:Whipple Disease / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D002443:Ceftriaxone