title: Diagnosis of Whipple's disease using molecular biology techniques.
abstract: The diagnosis of Whipple's disease (WD) is based on the existence of clinical signs and symptoms compatible with the disease and in the presence of PAS-positive diastase-resistant granules in the macrophages of the small intestine. If there is suspicion of the disease but no histological findings or only isolated extraintestinal manifestations, species-specific PCR using different sequences of the T. whippleii genome from different tissue types and biological fluids is recommended.This study reports two cases: the first patient had diarrhea and the disease was suspected after an endoscopic examination of the ileum, while the second patient had multi-systemic manifestations,particularly abdominal, thoracic, and peripheral lymphadenopathies. In both cases, the diagnosis was confirmed using molecular biology techniques to samples from the small intestine or from a retroperineal lymph node, respectively.
authors.affiliation: Department of Digestive Diseases, Hospital Donostia, San Sebastián, Guipuzcoa, Spain. acosme@chdo.osakidetza.net
authors.forename: Ángel
authors.initials: Á
authors.lastname: Cosme
authors.forename: Evelia
authors.initials: E
authors.lastname: Ojeda
authors.forename: Ana I
authors.initials: AI
authors.lastname: Muñagorri
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gaminde
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.forename: Mikel
authors.initials: M
authors.lastname: Larzabal
authors.forename: Inés
authors.initials: I
authors.lastname: Gil
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000209:etiology; D004386:Duodenum / Q000382:microbiology / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005838:Genotype; D005910:Glioma / Q000209:etiology; D006801:Humans; D007082:Ileum / Q000382:microbiology / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D012187:Retroperitoneal Space; D021521:Ribotyping; D015173:Supratentorial Neoplasms / Q000209:etiology; D013702:Temporal Lobe / Q000473:pathology; D054851:Tropheryma / Q000235:genetics / Q000302:isolation & purification*; D008061:Whipple Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents