Whipple’s syndrome: literature review and case report
Kupriyanova I.N.1, Berdnikov R.B.2, Bozrov R.M.3
1 Ural State Medical University, Yekaterinburg
2 Ural Research Institute of Phthisiopulmonology, Yekaterinburg
3 «354 Military Clinical Hospital», the Ministry of Defense of Russia, Yekaterinburg
Whipple’s syndrome (WS) is a rare chronic systemic infectious disease caused by the gram-positive bacterium Tropheryma whipplei (TW). Primary TW infection occurs in the fecal-oral or oral-oral route in early childhood and proceeds asymptomatically or with the clinic of rapidly jugulated gastroenteritis, pneumonia, followed by elimination of the pathogen. The article presents the clinical case of the diagnosed WS. Comparison of own clinical observation with literature data is carried out. The features of WS in a patient of 36 years were the fever, severe weight loss, generalized lymphadenopathy, including retroperitoneal lymph nodes, with the absence of joint and gastrointestinal syndromes. This required differential diagnostics with infectious, lymphoproliferative diseases. The diagnosis was established after one year from the onset of the disease when PAS-positive macrophages were detected in the small intestine mucosa. The use of ceftriaxone therapy for 14 days, maintenance therapy with trimethoprim-sulfamethoxazole (160 mg / 800 g per day), led to a positive clinical and laboratory dynamics in 9 months, a decrease in PAS-positive macrophages in the intestine.
Key words: Whipple’s disease, lymphadenopathy of retroperitoneal lymph nodes, PAS-positive macrophages.
For citation: Kupriyanova I.N., Berdnikov R.B., Bozrov R.M. Whipple’s syndrome: literature review and case report //
RMJ. Medical Review. 2018. № 1(II). P. 85–92.
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