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Case report
Whipple’s disease: imaging contribution for a challenging case
  1. Ana Aguiar Ferreira1,
  2. Paula Gomes1,
  3. Luís Curvo-Semedo1,2 and
  4. Paulo Donato1,2
  1. 1Medical Imaging, Coimbra University Hospital Centre, Coimbra, Portugal
  2. 2Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Ana Aguiar Ferreira; ana.aguiar.f{at}gmail.com

Abstract

Whipple’s disease is a rare and difficult-to-diagnose infectious disease, related to infection by gram-positive bacillum Tropheryma whipplei. Clinical manifestations are very variable, but the classic form usually begins with recurring arthritis, followed several years later by non-specific abdominal symptoms, leading to late diagnosis. We present the case of a 52-year-old man who was admitted in the emergency department with an insidious clinical picture characterised by weight loss, abdominal pain, diarrhoea and arthralgias. An abdominal ultrasound was performed, showing findings suggestive of Whipple’s disease, which, in conjunction with the clinical and laboratory findings, allowed the diagnosis to be correctly addressed. Upper endoscopy with duodenal biopsy revealed findings compatible with Whipple’s disease, and the diagnosis was also confirmed through PCR techniques of blood. The patient was given antibiotic therapy, with rapid and substantial clinical improvement.

  • radiology
  • malabsorption
  • gastroenterology
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Footnotes

  • Contributors AAF wrote the article and together with PG and LCS interpreted the ultrasound and CT scan. LCS and PD reviewed and edited the article in its final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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