Intestinal Research

Yoshiko Igarashi

1 Article

Infection

Whipple disease mimicking inflammatory bowel disease: Maiko Tatsuki, Takashi Ishige, Yoshiko Igarashi, Reiko Hatori, Akira Hokama, Junko Hirato, Aleixo Muise, Takumi Takizawa, Hirokazu Arakawa; Intest Res 2021;19(1):119-125. Published online July 3, 2020; DOI: https://doi.org/10.5217/ir.2019.09177

Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acidSchiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy.

Citations

Citations to this article as recorded by

Through the Looking Glass: A Child With Arthralgia, Malaise and Weight Loss
Aline R. Verhage, Iris D. Nagtegaal, Cathelijne van der Feen, Tom F.W. Wolfs
Pediatric Infectious Disease Journal.2023; 42(7): 629. CrossRef
Enfermedad de Whipple: revisión sistemática de la literatura
Ledmar Jovanny Vargas Rodriguez, Jeinny Lucero Ruiz Muñoz, Paola Andrea Bolivar Córdoba, Monica Dayana Romero Cely, Ervirson Jair Cañon Abril, Zulma Marisol Suarez Correa, María Angélica Mendoza Cáceres
Revista colombiana de Gastroenterología.2023; 38(1): 35. CrossRef
Whipple’s Disease with Colonic Involvement: A Rare Endoscopic Documentation
Verónica Gamelas, Ines Canha, João Pimentel, Sara Santos, Verónica Borges, Carlos Bernardes
GE - Portuguese Journal of Gastroenterology.2022; 29(6): 436. CrossRef
Whipple’s disease with normal duodenal histology diagnosed by ileal biopsy using balloon endoscopy
Hideki Mori, Chiaki Yakabi, Kiwamu Yonahara, Kazunao Hamahiga, Miyu Yoshimura, Masaki Sakihara, Kenji Ishihara, Kinya Azama, Takayuki Chinen, Osamu Zaha
Clinical Journal of Gastroenterology.2022; 15(4): 702. CrossRef

9,619 View
194 Download
3 Web of Science
4 Crossref

Author index