Intestinal Research

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

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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

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Miscellaneous

Bloating in a supine position: Akira Hokama, Yasuka Nakada, Aki Yanagida, Erika Koga, Kunikazu Hoshino, Jiro Fujita; Intest Res 2021;19(2):252-253. Published online June 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00019

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Inflammatory bowel diseases

Sausage-like fingers in Crohn’s disease: Akira Hokama, Taiga Miyagi, Yukiko Takeichi, Eriko Uema, Sayuri Takehara, Tetsuya Ohira, Atsushi Iraha, Tetsu Kinjo, Jiro Fujita; Intest Res 2020;18(3):341-342. Published online May 25, 2020; DOI: https://doi.org/10.5217/ir.2020.00036

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IBD

Stroke and neck bruit in a boy with Crohn’s disease: Ryosaku Tomiyama, Akira Hokama, Erika Koga, Kohei Shimabukuro, Yuiko Oishi, Tetsuya Ohira, Atsushi Iraha, Tetsu Kinjo, Jiro Fujita; Intest Res 2019;17(4):565-566. Published online April 15, 2019; DOI: https://doi.org/10.5217/ir.2019.00019

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IBD

A pulmonary nodule in a patient with Crohn’s disease: Akira Hokama, Shusaku Haranaga, Takanobu Sasaki, Hirofumi Matsumoto, Tetsuya Ohira, Atsushi Iraha, Tetsu Kinjo, Saifun Nahar, Jiro Fujita; Intest Res 2019;17(3):438-439. Published online February 11, 2019; DOI: https://doi.org/10.5217/ir.2019.00010

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IBD

Distribution of cytomegalovirus genotypes among ulcerative colitis patients in Okinawa, Japan: Saifun Nahar, Akira Hokama, Atsushi Iraha, Tetsuya Ohira, Tetsu Kinjo, Tetsuo Hirata, Takeshi Kinjo, Gretchen L. Parrott, Jiro Fujita; Intest Res 2018;16(1):90-98. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.90

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<b>Background/Aims</b><br/>

To determine the prevalence of glycoprotein B (gB), glycoprotein N (gN), and glycoprotein H (gH) genotypes of human cytomegalovirus (HCMV) superimposed on ulcerative colitis (UC) patients in Japan.

Methods

Four archived stool samples and 7-archived extracted DNA from stool samples of 11 UC patients with positive multiplex polymerase chain reaction (PCR) results for HCMV were used UL55 gene encoding gB, UL73 gene encoding gN, and UL75 gene encoding gH were identified by PCR. Genotypes of gB and glycoprotein N were determined by sequencing.

Results

Among 11 samples, 8 samples were amplified through PCR. gB, gN, and gH genotypes were successfully detected in 3 of 8 (37.5%), 4 of 8 (50%), and 8 of 8 (100%), respectively. The distribution of gB and gN genotypes analyzed through phylogenetic analysis were as follows: gB1 (2/3, 66.7%), gB3 (1/3, 33.3%), gN3a (2/4, 50%), and gN3b (2/4, 50%). Other gB genotypes (gB2 and gB4) and gN genotypes (gN1, gN2, and gN4) were not detected in this study. Out of successfully amplified 8 samples of gH genotype, gH1 and gH2 were distributed in 12.5% and 75% samples, respectively. Only 1 sample revealed mixed infection of gH genotype. The distribution of gH1 and gH2 differed significantly (1:6, P<0.05) in UC patients. The distribution of single gH genotype also revealed significant difference in UC patients who were treated with immunosuppressive drug (P<0.05).

Conclusions

In this study, gB1, gN3, and gH2 gene were determined as the most frequently observed genotypes in UC patients, which suggest that there might be an association between these genotypes of HCMV and UC.

Citations

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Significance of Cytomegalovirus gB Genotypes in Adult Patients Undergoing Hematopoietic Stem Cell Transplantation: Insights from a Single-Centre Investigation
Tamara Vasiljevic, Marko Jankovic, Ana Tomic, Ida Bakrac, Stefan Radenovic, Danijela Miljanovic, Aleksandra Knezevic, Tanja Jovanovic, Irena Djunic, Milena Todorovic-Balint
Pharmaceuticals.2024; 17(4): 428. CrossRef
Cytomegalovirus Genotype Distribution among Congenital and Perinatal Infected Patients with CMV-Associated Thrombocytopenia
Hongbo Hu, Wenwen Peng, Qiaoying Peng, Ying Cheng
Fetal and Pediatric Pathology.2022; 41(1): 77. CrossRef
Cytomegalovirus Genotype and Virulence in Infants with Congenital Infection
Hong-bo Hu, Jian-gang Wu, Jian-jun Sun, Qiao-ying Peng, Xiao-peng Shang
Journal of Pediatric Infectious Diseases.2021; 16(04): 171. CrossRef
Common Polymorphisms in the Glycoproteins of Human Cytomegalovirus and Associated Strain-Specific Immunity
Hsuan-Yuan Wang, Sarah M. Valencia, Susanne P. Pfeifer, Jeffrey D. Jensen, Timothy F. Kowalik, Sallie R. Permar
Viruses.2021; 13(6): 1106. CrossRef
Cytomegalovirus and Inflammatory Bowel Diseases (IBD) with a Special Focus on the Link with Ulcerative Colitis (UC)
Alexandre Jentzer, Pauline Veyrard, Xavier Roblin, Pierre Saint-Sardos, Nicolas Rochereau, Stéphane Paul, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
Microorganisms.2020; 8(7): 1078. CrossRef

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