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Whipple’s disease: a rare case of malabsorption
  1. Ana Lopes1,
  2. Ana Filipa Santos2,
  3. Maria Joana Alvarenga1,
  4. Alberto Mello e Silva1
  1. 1Department of Medicina Interna, Hospital Egas Moniz, Lisbon, Portugal
  2. 2Department of Pneumologia, Hospital Egas Moniz, CHLO, Lisboa, Portugal
  1. Correspondence to Dr Ana Lopes, acferrazlopes{at}


Whipple’s disease is a chronic, rare, multisystemic, infectious entity, described for the first time in 1907. Its aetiological agent is the Gram-negative rod, Tropheryma whipplei, which was isolated for the first time in 2001 from a cardiac valve of a patient with endocarditis. We present the case of a 71-year-old man, who came into the emergency room complaining of anorexia, weakness, abdominal pain and diarrhoea with haematochezia and presented disseminated palpable purpuric lesions, predominantly in the lower limbs. The upper endoscopy showed a duodenal vasculitis and the biopsy of that location revealed aspects suggestive of Whipple’s disease. We started him on antibiotics according to the recent orientations with progressive clinical and analytical improvement, although he developed an immune reconstitution syndrome, which lasted for 2 weeks.

  • vasculitis
  • GI bleeding
  • malabsorption
  • infection (gastroenterology)
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  • Contributors AL: conception and design, acquisition of data or analysis and interpretation of data. AFS: acquisition of data. MJA: drafting the article or revising it critically for important intellectual content. AMS: final approval of the version published. MJA and AMS: agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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