Manifestaciones infrecuentes de la enfermedad de Whipple. Estudio de cuatro casos

Ojeda, E; Cosme, Ángel; Lapaza, J.; Torrado, Julio; Arruabarrena, I.; Alzate, Luis

doi:10.1016/s0304-4858(05)74503-0

Cited by 2 publications

(2 citation statements)

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“…Compatible histology: non-caseating granulomas, other pathologies ruled out, and response to antibiotics. These patients' clinical and epidemiological characteristics were analysed and four of our own patients who attended in the period 1994-2000 but whose cases were reported subsequently were included (12).…”

Section: Methodsmentioning

confidence: 99%

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Whipple's disease in Spain: a clinical review of 91 patients diagnosed between 1947 and 2001

Ojeda

Cosme²,

Lapaza

et al. 2010

Rev. esp. enferm. dig.

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Background: to determine the epidemiological, clinical, diagnostic and therapeutic characteristics of Whipple's disease in Spain.Patients and method: cases of Whipple's disease reported in the Spanish literature between 1947 and 2001 which meet histological or PCR criteria are reviewed.Results: 91 cases were included, 87.5% of which were male. The maximum incidence was between 40 and 60 years of age (68%). There was no family clustering or susceptibility by profession or surroundings. The most common symptoms and signs were: weight loss (80%), diarrhoea (63%), adenopathies (35%), skin problems (32%), abdominal pain (27%), fever (23%), joint problems (20%) and neurological problems (16%). Arthralgias, diarrhoea and fever were noted prior to diagnosis in 58, 18 and 13% of patients, respectively. Diagnosis was histological in all cases except two, which were diagnosed by PCR. Intestinal biopsy was positive in 94%. Adenopathic biopsies (mesenteric or peripheral) were suggestive in 13% of cases, and treatment was effective in 89%. There were nine relapses, four of which were neurological, although all occurred before the introduction of cotrimoxazole.Conclusions: Whipple's disease is not uncommon, although it requires a high degree of suspicion to be diagnosed in the absence of digestive symptoms. The most common and most sensitive diagnostic method is duodenal biopsy. PCR is beginning to be introduced to confirm the diagnosis and as a therapeutic control. Initial antibiotic treatment with drugs that cross the blood-brain barrier, such as cotrimoxazole and ceftriaxone, is key to achieving a cure and avoiding relapses.

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Section: Methodsmentioning

confidence: 99%

“…Histología compatible: granulomas no caseificantes, descartadas otras patologías y con respuesta antibiótica. Se analizan los rasgos clínicos y epidemiológicos de los pacientes a los que se añaden 4 propios del periodo 1994-2000 aunque su publicación fue posterior (12).…”

Section: Pacientes Y Métodounclassified