title: Whipple's Disease: Our Own Experience and Review of the Literature.
abstract: Whipple's disease is a chronic infectious systemic disease caused by the bacterium Tropheryma whipplei. Nondeforming arthritis is frequently an initial complaint. Gastrointestinal and general symptoms include marked diarrhoea (with serious malabsorption), abdominal pain, prominent weight loss, and low-grade fever. Possible neurologic symptoms (up to 20%) might be associated with worse prognosis. Diagnosis is based on the clinical picture and small intestinal histology revealing foamy macrophages containing periodic-acid-Schiff- (PAS-) positive material. Long-term (up to one year) antibiotic therapy provides a favourable outcome in the vast majority of cases. This paper provides review of the literature and an analysis of our 5 patients recorded within a 20-year period at a tertiary gastroenterology centre. Patients were treated using i.v. penicillin G or amoxicillin-clavulanic acid + i.v. gentamicin for two weeks, followed by p.o. doxycycline (100 mg per day) plus p.o. salazopyrine (3 g per day) for 1 year. Full remission was achieved in all our patients.
authors.affiliation: 2nd Department of Medicine-Gastroenterology, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, 50005 Hradec Králové, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bureš
authors.forename: Marcela
authors.initials: M
authors.lastname: Kopáčová
authors.forename: Tomáš
authors.initials: T
authors.lastname: Douda
authors.forename: Jolana
authors.initials: J
authors.lastname: Bártová
authors.forename: Jan
authors.initials: J
authors.lastname: Tomš
authors.forename: Stanislav
authors.initials: S
authors.lastname: Rejchrt
authors.forename: Ilja
authors.initials: I
authors.lastname: Tachecí