title: A case of Noonan syndrome and Whipple's disease in the same patient.
abstract: We report the first known case of both Noonan syndrome and Whipple's disease occurring in the same patient. A 36-year-old female with history of Noonan syndrome developed fatigue, anorexia, arthritis of the knees and hands with a diffuse hyperpigmented rash, night sweats, and an unintentional fifteen pound weight loss over 4 mo. Small bowel enteroscopy demonstrated mild edematous yellowish mucosa without friability. Random small bowel biopsies revealed extensive periodic acid-Schiff positive material within the foamy macrophages. She was treated with a 12 mo course of trimethoprim-sulfamethoxazole DS with clinical improvement to baseline status.
authors.affiliation: Cedars-Sinai Medical Center, 8700 Beverly Blvd, Room 5512, Los Angeles, California, CA 90048, USA. sundip.karsan@cshs.org
authors.forename: Sundip S
authors.initials: SS
authors.lastname: Karsan
authors.forename: Hetal A
authors.initials: HA
authors.lastname: Karsan
authors.forename: Anand S
authors.initials: AS
authors.lastname: Karsan
authors.forename: James Ian
authors.initials: JI
authors.lastname: McMillen