title: Whipple's disease.
abstract: Whipple's disease is a rare chronic multi-systemic infection, caused by Gram-positive bacillus Tropheryma whipplei. The infection usually involves the small bowel, but other organs may also be involved. The diagnosis is often challenging and can only be made on histopathological examination. This report describes 2 patients presenting with abdominal pain and weight loss who finally were diagnosed to have Whipple's disease. One of the patients was a renal transplant recipient. To the best of authors' knowledge, no case of Whipple's disease has yet been reported in Pakistan. The diagnosis were made on the basis of histopathological evaluation of duodenal biopsies. The cases underscore the need for diligent histopathological evaluation of the upper gastrointestinal biopsies and a high index of suspicion for an accurate diagnosis of the condition. The approach to the diagnosis and management of the condition is discussed.
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Syed Mudassir
authors.initials: SM
authors.lastname: Laeeq
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Nasir Hassan
authors.initials: NH
authors.lastname: Luck
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Syed Mujahid
authors.initials: SM
authors.lastname: Hassan
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Zaigham
authors.initials: Z
authors.lastname: Abbas
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Tasneem
authors.affiliation: Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Mubarak
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D002443:Ceftriaxone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D010154:Pakistan; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D054851:Tropheryma / Q000302:isolation & purification*; D015431:Weight Loss; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination