Clinical case of Whipple’s disease

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The article presents a clinical case of 68-years old patient with a Whipple’s disease. The diagnosis was made after 10 years of following-up in presence of gastroenterological symptoms. On examination flattened rounded villi with the content of PAS-positive (PAS — periodic acid Schiff) foamy macrophages, highly specific for Whipple’s disease, have been described in the biopsy specimen of the distal duodenum. The therapy led to a distinct positive dynamics persisting for 1 year.

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作者简介

Marina Osipenko

Novosibirsk State Medical University

Email: ngma@bk.ru
ORCID iD: 0000-0002-5156-2842
SPIN 代码: 5404-1121
Scopus 作者 ID: 6701825144

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Novosibirsk

Aleksandr Nadeev

Novosibirsk State Medical University

Email: nadeevngma@mail.ru
ORCID iD: 0000-0001-9312-6566
SPIN 代码: 8777-9748

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Novosibirsk

Yuliya Venzhina

Novosibirsk Region, City Infection Hospital Nо 1

Email: yulya.venzhina@mail.ru
ORCID iD: 0000-0001-8579-2913
SPIN 代码: 5704-3788

MD, Cand. Sci. (Med.)

俄罗斯联邦, Novosibirsk

Elena Zhuk

Novosibirsk State Medical University

编辑信件的主要联系方式.
Email: ezhuk@mail.ru
ORCID iD: 0000-0002-7416-5428
SPIN 代码: 9972-7776

MD, Dr. Sci. (Med.), Assistant Professor

俄罗斯联邦, Novosibirsk

参考

  1. Kupriyanova IN, Berdnikov RB, Bozrov RM. Whipple disease: review of literature and clinical observation. Russian Medical Inquiry. 2018;1(1–2):85–92. (In Russ.)
  2. Kutlu O, Erhan SS, Gökden Y, et al. Whipple’s disease: A case report. Med Princ Pract. 2020;29(1):90–93. doi: 10.1159/000498909
  3. Martinetti M, Biagi F, Badulli C, et al. The HLA alleles DRB1*13 and DQB1*06 are associated to Whipple’s disease. Gastroenterology. 2009;136(7):2289–2294. doi: 10.1053/j.gastro.2009.01.051
  4. Belov BS. Whipple disease. Russian Medical Journal. 2014;22(28):2063–2067. (In Russ.)
  5. Churin YuA, Pavlovskikh SP, Kupriyanova IN, Berdnikov RB. Features of management tactics of Whipple’s disease. Proceedings of IV International (74th All-Russian) scientific and practical conference “Actual issues of modern medical science and health care”; 2019 April 1–12; Ekaterinburg. Ekaterinburg; 2019. P. 497–503. (In Russ.)
  6. Raoult D, Birg ML, La Scola B, et al. Cultivation of the bacillus of Whipple disease. N Engl J Med. 2000;342(9):620–625. doi: 10.1056/NEJM200003023420903
  7. Lagier J-C, Raoult D. Whipple’s disease and Tropheryma whipplei infections: when to suspect them and how to diagnose and treat them. Curr Opin Infect Dis. 2018;41(6):463–470. doi: 10.1097/QCO.0000000000000489
  8. Schneider T, Moos V, Loddenkemper C, et al. Whipple disease: new aspects of pathogenesis and treatment. Lancet Infect Dis. 2008;8(3):179–190. doi: 10.1016/S1473-3099(08)70042-2
  9. Durand DV, Lecomte C, Cathébras P, et al. Whipple disease. Clinical review of 52 cases. The SNFMI Research Group on Whipple Disease. Société Nationale Française de Médecine Interne. Medicine (Baltimore). 1997;76(3):170–184. doi: 10.1097/00005792-199705000-00003
  10. Misbah SA, Mapstone NP. Whipple’s disease revisited. J Clin Pathol. 2000;53(10):750–755. doi: 10.1136/jcp.53.10.750

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1. JATS XML
2. Fig. 1. Duodenal mucous membrane with sub-lysis base, presented unevenly located branched villi of different height. Coloring of hematoxylin and eosin. Zoom ×100

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3. Fig. 2. In the mucosal stroma, large polynomial macrophages with foam cytoplasm are defined (indicated by the arrows). Slight inflammatory infiltration, represented by lymphocytes, plasmacytes, single neutrophils. Sclerosis, round optically transparent spaces (by fat vacuole type). Coloring of hematoxylin and eosin. Zoom ×400

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4. Fig. 3. PAS positive (PAS — periodic acid Schiff) macrophages (indicated by the arrows). Coloring with PAS reagent. Zoom ×400

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版权所有 © Osipenko M., Nadeev A., Venzhina Y., Zhuk E., 2022

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