title: Whipple's Disease in an Afro-Caribbean National.
abstract: Whipple's disease is a rare multi-organ infectious disease caused by Tropheryma whipplei. It is fatal without treatment. We report on a 40-year old Afro-Jamaican man who presented with a six-month history of weight loss and diarrhoea. Investigations revealed iron deficiency anaemia and hypoalbuminaemia. Upper gastrointestinal endoscopy revealed white patchy lesions in the duodenum. The duodenal biopsy showed broadening and thickening of the villi by a dense infiltrate of foamy histiocytes within the lamina propria and focally extending into the attached submucosa. Periodic Acid-Schiff stains were positive. Electron microscopy was confirmatory and polymerase chain reaction testing conclusively identified the organisms as T whipplei. Antibiotic treatment resulted in resolution of symptoms. Although the diagnosis of Whipple's disease is difficult, increased awareness should lead to an increase in reported cases with the improvements in diagnostic capabilities.
authors.affiliation: Department of Medicine, The University of the West Indies, Kingston 7, Jamaica.
authors.forename: D O
authors.initials: DO
authors.lastname: Whittle
authors.affiliation: Department of Pathology, The University of the West Indies, Kingston 7, Jamaica.
authors.forename: N P
authors.initials: NP
authors.lastname: Williams
authors.affiliation: Department of Microbiology, The University of the West Indies, Kingston 7, Jamaica.
authors.forename: A M
authors.initials: AM
authors.lastname: Nicholson
authors.affiliation: Department of Medicine, The University of the West Indies, Kingston 7, Jamaica.
authors.forename: K
authors.initials: K
authors.lastname: King-Robinson
authors.affiliation: Department of Pathology and Laboratory Medicine and Microbiology, Mount Sinai Hospital, Toronto, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Kirsch
authors.affiliation: Department of Pathology and Laboratory Medicine and Microbiology, Mount Sinai Hospital, Toronto, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Riddell
authors.affiliation: University of Toronto, Toronto, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Mazzulli
authors.affiliation: Department of Medicine, The University of the West Indies, Kingston 7, Jamaica. michael.lee@uwimona.edu.jm.
authors.forename: M G
authors.initials: MG
authors.lastname: Lee