Whipple's disease is an infrequent multisystemic infection caused by a gram-positive bacterium: Tropheryma whippelii, which after several studies has been characterized as an actinomiceto por 16Sr RNA. It occurs with multiple symptoms, the principal of which are diarrhea, weight loss, stomach pain and arthralgias. Arthritis or artralgia may appear as an isolated symptom and eventually through the years additional digestive, cardiovascular and/or neurological symptoms arise. Diverse immunological abnormalities usually present before or after clinical symptoms are first discovered. Currently there are cabinet, endoscopic, radiological, tomographic and laboratory studies which can help to make a definitive diagnosis, such as the duodenal biopsy submitted to the Schiff test, to the polimerasa chain or an electronic microscopy in order to see the intracellular bacteria in the macrophage and for immunohistochemistry to see specific antibodies to Whipple's disease. Treatment is trimetoprim/sulfametoxazol, it is suggested transfer factor too.
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JCEM Case Rep
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Division of Endocrinology, Diabetes & Metabolic Diseases, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
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Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
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