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whipples disease

Antoine Guérin, Gaspard Kerner, Nico Marr, Janet G Markle, Florence Fenollar, Natalie Wong, Sabri Boughorbel, Danielle T Avery, Cindy S Ma, Salim Bougarn, Matthieu Bouaziz, Vivien Beziat, Erika Della Mina, Carmen Oleaga-Quintas, Tomi Lazarovt, Lisa Worley, Tina Nguyen, Etienne Patin, Caroline Deswarte, Rubén Martinez-Barricarte, Soraya Boucherit, Xavier Ayral, Sophie Edouard, Stéphanie Boisson-Dupuis, Vimel Rattina, Benedetta Bigio, Guillaume Vogt, Frédéric Geissmann, Lluis Quintana-Murci, Damien Chaussabel, Stuart G Tangye, Didier Raoult, Laurent Abel, Jacinta Bustamante, Jean-Laurent Casanova
Most humans are exposed to Tropheryma whipplei (Tw). Whipple's disease (WD) strikes only a small minority of individuals infected with Tw (<0.01%), whereas asymptomatic chronic carriage is more common (<25%). We studied a multiplex kindred, containing four WD patients and five healthy Tw chronic carriers. We hypothesized that WD displays autosomal dominant (AD) inheritance, with age-dependent incomplete penetrance. We identified a single very rare non-synonymous mutation in the four patients: the private R98W variant of IRF4, a transcription factor involved in immunity...
March 14, 2018: ELife
Ana Lopes, Ana Filipa Santos, Maria Joana Alvarenga, Alberto Mello E Silva
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...
March 5, 2018: BMJ Case Reports
K Homsy, J-L Paquay, H Farghadani
INTRODUCTION: Pancreatic cancer is a rare disease with a high mortality rate, for which complete surgical resection, when possible, is the preferred therapeutic. Pancreaticoduodenectomy represents the surgical technique of choice. Abdominal surgeons can be faced with the challenge of patients with a history of coronary artery bypass graft in which the right gastro-epiploic artery is used. CASE REPORT: We report the case of a patient with an adenocarcinoma of the pancreatic head, stage IIA, having previously undergone a triple coronary artery bypass, one of which being a right gastro-epiploic graft...
February 20, 2018: Acta Chirurgica Belgica
William W Tseng, Denice D Tsao-Wei, Dario Callegaro, Giovanni Grignani, Lorenzo D'Ambrosio, Sylvie Bonvalot, Cecilia G Ethun, Kenneth Cardona, John T Mullen, Robert J Canter, John E Mullinax, Ricardo J Gonzalez, Frits van Coevorden, Markus Albertsmeier, Kiran K Dhanireddy, Salvatore L Renne, Alessandro Gronchi
BACKGROUND: In retroperitoneal sarcoma (RPS), the optimal extent of resection must balance adequate disease control with potential for morbidity. We sought to study the frequency and outcomes after a Whipple procedure or pancreaticoduodenectomy (PD) in patients undergoing resection for primary RPS. METHODS: Participating referral centers within the Trans-Atlantic Retroperitoneal Sarcoma Working Group provided retrospective data from January 2007 to December 2016 for patients with primary RPS who underwent PD along with the total number of consecutive resections done during the same time period...
February 5, 2018: European Journal of Surgical Oncology
Dereck L Salisbury, Mary O Whipple, Marsha Burt, Rebecca J L Brown, Alan Hirsch, Christopher Foley, Diane Treat-Jacobson
The purpose of this study was to implement and evaluate quality outcomes including referral, enrollment, and completion rates of a new peripheral artery disease (PAD)-specific supervised exercise therapy (SET) program within a preexisting clinical exercise wellness program and to evaluate the clinical effectiveness and patient-centered outcomes derived from 12 weeks of PAD-specific SET. Recruited participants completed an individualized, minimally supervised, PAD-specific SET program based on the AHA-ACC guidelines...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Hiroaki Saito, Junji Shiode, Shogen Ohya, Atsushi Yao, Shunsuke Saito, Masakuni Fujii, Mamoru Itoh, Shuhei Ishiyama, Akiko Fujiwara, Junichiro Nasu, Masao Yoshioka, Kazuhide Yamamoto
A 72-year-old man presented with anorexia and 15-kg weight loss over 3 years. Endoscopy revealed yellow, shaggy mucosa alternating with erythematous, eroded mucosa in the duodenum. Biopsy specimens showed massive infiltration of periodic acid-Schiff-positive macrophages in the lamina propria, consistent with Whipple's disease. The patient was treated with intravenous ceftriaxone for four weeks, followed by oral trimethoprim-sulfamethoxazole. His condition improved, and he gradually gained weight. Although the endoscopic findings improved with continuous trimethoprim-sulfamethoxazole administration, macrophage infiltration of the duodenal mucosa persisted...
February 9, 2018: Internal Medicine
Izabela Dymon, Justyna Tabaka-Pradela, Katarzyna Anna Knast, Dominika Dudek, Monika Rudzińska
INTRODUCTION: Whipple's disease (WD) is a chronic, multisystemic infectious disease caused by Gram-positive bacillus Tropheryma whipplei (T.w.). Its common symptoms arise in the digestive system, however, during the infection the CNS (Central Nervous System) may also be affected. AIM: The aim of this work is to present a case report of a patient diagnosed with Whipple's disease with dominant neuropsychological and behavioural complications in the late phase. CONCLUSIONS: Whipple's disease is a rare disease with possible neurological and neuropsychiatric complications...
October 29, 2017: Psychiatria Polska
Sara El Rharras, Emeline Minichiello, Luca Semerano
No abstract text is available yet for this article.
December 28, 2017: Joint, Bone, Spine: Revue du Rhumatisme
Anju Bansal, Varsha Dalal, Manveen Kaur, Fouzia Siraj
Background: Periampullary neoplasms include carcinomas of the duodenum, ampulla of Vater, distal common bile duct, and pancreas. The aggressive course of these neoplasms is attributable to the delay in diagnosis, as patients have no symptoms until advanced stages of the disease. More than half of patients have distant metastasis at the time of diagnosis. The most frequent sites of metastasis are the liver, lymph nodes, peritoneum, lung, bone, kidney, and, rarely the skin. Case Report: We report the case of a 45-year-old female patient with adenocarcinoma of the ampulla of Vater metastasizing to the right parietal skull with overlying cutaneous involvement 1 year after a Whipple procedure...
2017: Ochsner Journal
Julia Dick, Patrizia Krauß, Jost Hillenkamp, Britta Kohlmorgen, Christoph Schoen
Introduction. Tropheryma whipplei is the causative agent of Whipple's disease. Gastrointestinal and lymphatic tissues are affected in the majority of cases, resulting in diarrhoea, malabsorption and fever. Here, we report a rare case of ocular manifestation in a patient lacking the typical Whipple symptoms. Case presentation. A 74-year-old Caucasian female presented with blurred vision in the right eye over a period of 1-2 months, accompanied by stinging pain and conjunctival hyperaemia for the last 2 days...
October 2017: JMM Case Reports
Alessandra Loiodice, Giuseppe Losurdo, Andrea Iannone, Roberta Rossi, Maria Grazia Fiore, Domenico Piscitelli
A 61-year-old woman received a diagnosis of undifferentiated non-erosive arthritis in 2010 and assumed methotrexate and steroids in 2014. After 1 year, she experienced watery diarrhea, vomiting, fever, weight loss, and severe hypoalbuminemia, thus being admitted into our Unit. Esophagogastroduodenoscopy showed duodenal lymphangiectasia and duodenal biopsy samples several foamy PAS-positive macrophages and villous subtotal atrophy. Transmission electron microscope demonstrated several extracellular and intracellular rod-shaped bacteria (Tropheryma whipplei)...
November 20, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Meng Zhu, Ning Zhang, Wei Tao, Zhitao Wang, Shuixiang He
Pancreatic tuberculosis (TB) is an extremely rare form of extrapulmonary tuberculosis even in endemic areas that masquerades as a mass or inflammation because of lack of typical clinical manifestations and radiologic features and therefore usually misdiagnosed as a pancreatic malignancy or pancreatitis. Here we present a 23-year-old young man with pancreatic tuberculosis mimicking pancreatic head carcinoma A man who suffered from upper abdominal pain and nausea for half a month was admitted to our hospital...
2017: Case Reports in Medicine
Amber W Kinsey, Matthew Whipple, Lauren Reid, Olivia Affuso
BACKGROUND: Sedentary behavior (SB) is a significant risk factor for heart disease, diabetes, obesity, and early mortality, particularly among women, and the health consequences associated with SB are independent of physical activity status. Interventions utilizing wearable technologies can improve SB, but their effectiveness is influenced by individual preferences, device engagement strategies, and technological features, which may affect user compliance. Gathering a priori insight from target populations on their preferences for program tools and strategies may assist researchers in identifying effective methods to improve the efficacy of SB interventions...
October 20, 2017: JMIR Human Factors
Guilherme Almeida Rosa da Silva, José Soares Pires Neto
No abstract text is available yet for this article.
September 2017: Revista Brasileira de Reumatologia
Trace Heavener, Michelle Thompson, Chhaya Patel, Lisa Forrester, Donald Rawls
Whipple's disease is an infection caused by the Gram-positive bacillus Tropheryma whipplei. Invasion or uptake of the bacteria can occur in various parts of the body. The differential diagnoses are broad due to the wide spectrum of infection, and the disease is diagnosed based on biopsy of suspected lesions, usually in the small intestine. We present the case of a 56-year-old man with no significant prior medical history who presented with swelling and pain in the left eye. Review of systems revealed 6 months of persistent diarrhea, and intestinal biopsy revealed periodic acid-Schiff-positive macrophages...
October 2017: Proceedings of the Baylor University Medical Center
Jean-Marie Berthelot, Xavier Puéchal
Whipple's disease can mimic spondyloarthritis (SpA) or rheumatoid arthritis (RA) for many years and, in a few cases, induces the development of antibodies to cyclic citrullinated peptides. The causative agent Tropheryma whipplei can smolder within cells, including macrophages, by suppressing the xenophagic process, a type of selective autophagy that targets pathogens. Other inflammatory joint diseases may also stem from impaired xenophagy with persistence of bacteria or viruses that can eventually migrate from the mucous membranes to the joints and entheses, where they may exert adverse effects on immune responses, even if they fail to replicate...
September 28, 2017: Joint, Bone, Spine: Revue du Rhumatisme
A Vankeerberghen, S Jonckheere, H De Raeve, R Caluwe, H De Beenhouwer
OBJECTIVES: A kidney transplant recipient with recurrent pleuritis underwent an open lung biopsy, the results of which revealed multiple nodular infiltrates. Grocott and periodic acid-Schiff staining were positive. Fungal and Tropheryma whipplei PCR were, however, negative. Further identification was needed. METHODS: Formalin-fixed, paraffin-embedded (FFPE) extraction was performed using an FFPE extraction kit. T. whipplei was searched for using a real-time PCR targeting the noncoding repeat specific for T...
September 28, 2017: Clinical Microbiology and Infection
Sadanandavalli Retnaswami Chandra, Lakshminarayanapuram Gopal Viswanathan, Anupama Ramakanth Pai, Rahul Wahatule, Suvarna Alladi
BACKGROUND: Dementias are fairly slowly progressive degenerative diseases of brain for which treatment options are very less and carry a lot of burden on family and society. A small percentage of them are rapidly progressive and mostly carry a different course outcome. However, there are no definite criteria other than the time line for these patients. AIMS: The aim of this was to identify and categorize the causes and course of rapidly progressive dementias seen in our center...
August 2017: Journal of Neurosciences in Rural Practice
Michael D Kluger, M Farzan Rashid, Vilma L Rosario, Beth A Schrope, Jonathan A Steinman, Elizabeth M Hecht, John A Chabot
INTRODUCTION: Modern-era systemic therapy for locally advanced pancreatic adenocarcinoma (LAPC) offers improved survival relative to historical regimens but not necessarily improved radiographic downstaging to allow more patients to undergo resection. The aim of this study was to evaluate the survival, progression, and pathologic outcomes after resection of LAPC that did not regress from > 180 degrees arterial encasement after neoadjuvant therapy. METHODS: Sixty-one LAPC patients were brought to the operating room after neoadjuvant therapy for NCCN-defined unresectable pancreatic cancer between 2012 and 2017...
September 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
E N Nweke, M N Ntwasa, M B Brand, J D Devar, M D Smith, G P Candy
BACKGROUND: Pancreatic cancer (PDAC) is a devastating cancer. It accounts for about 7% of cancer related deaths worldwide. During PDAC, several genes are altered. These alterations consequently lead to the progression of PDAC. Analysis of these alterations in the context of signalling pathways help in understanding the disease. METHOD: 18 Tissue (9 tumour, 9 normal) samples were obtained from Black South African stage I PDAC patients during the Whipple procedure...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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