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Whipple's disease

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https://www.readbyqxmd.com/read/28190362/unusual-presentation-of-obstructive-jaundice
#1
Alejandra Gordillo Hernández, Ángel Nogales Muñoz, Fernando Oliva Mompeán
Carcinoid tumors of the ampulla of Vater grow slowly and have an excellent prognosis after complete resection of local disease. Histopathological diagnosis is definitive, and the Whipple's procedure is performed as a standard at the present time, although more novel minimally-invasive techniques may be highly useful for selected patients. While tumor size is not a reliable marker of tumor aggression, it is nonetheless related to lymphatic invasion, hence an accurate diagnosis is important if the patient is to be offered the best option available for the treatment of their disease...
February 13, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28176790/architectural-and-functional-alterations-of-the-small-intestinal-mucosa-in-classical-whipple-s-disease
#2
H-J Epple, J Friebel, V Moos, H Troeger, S M Krug, K Allers, K Schinnerling, A Fromm, B Siegmund, M Fromm, J D Schulzke, T Schneider
Classical Whipple's disease (CWD) affects the gastrointestinal tract and rather elicits regulatory than inflammatory immune reactions. Mechanisms of malabsorption, diarrhea, and systemic immune activation are unknown. We here analyzed mucosal architecture, barrier function, and immune activation as potential diarrheal trigger in specimens from 52 CWD patients. Our data demonstrate villus atrophy and crypt hyperplasia associated with epithelial apoptosis and reduced alkaline phosphatase expression in the duodenum of CWD patients...
February 8, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28168330/whipple-s-disease-in-granulomatous-disguise-a-challenging-diagnosis-with-many-histopathological-pitfalls
#3
Mieke Van Bockstal, Anne Hoorens, Filip Van den Bosch, David Creytens, Sofie Verbeke, Jo Van Dorpe
No abstract text is available yet for this article.
February 6, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28121946/pancreatic-carcinosarcoma-with-rare-long-term-survival-case-report-and-review-of-the-literature
#4
Zhe Jia, Ke Zhang, RongHai Huang, XinGang Zhou, Li Jiang
PATIENT CONCERNS: We report a rare case of pancreatic carcinosarcoma involving a 44-year-old woman. The patient complained of discomfort associated with the upper abdomen and jaundice of skin and sclera for 1 week. DIAGNOSES: After hospitalization, relevant examinations were completed. The disease was diagnosed as carcinoma of the pancreatic head. INTERVENTIONS: Whipple procedure was conducted in May 2013. Intraoperative exploration indicated 2 components of the tumor: a fish-shaped gray matter and a hard structure similar to cancellous bone...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28098596/erythema-nodosum-leprosum-like-lesions-are-a-histopathologic-pattern-in-whipple-s-disease-and-a-sign-of-the-immune-reconstitution-inflammatory-syndrome-a-case-series-and-review-of-the-literature
#5
Julia Liersch, Agnès Carlotti, Anne Theunis, Alexandra Leonard, Mary Barrett, John Andrew Carlson, Jörg Schaller
Inflammatory and subcutaneous nodules can arise in treated and untreated cases of Whipple disease (WD). The inflammatory immune reconstitution syndrome describes paradoxical clinical inflammatory worsening of a preexisting condition because of a return of immune function. Clinicopathologic examination of 4 patients with WD who presented with erythema nodosum leprosum (ENL)-like lesions and the findings of a systematic review of this phenomenon revealed that ENL-like lesions occurred in predominantly middle-aged male patients who suffered from WD, mostly on the legs...
January 10, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/27980746/inflammatory-myofibroblastic-pancreas-tumor-a-case-report
#6
Muharrem Battal, Kinyas Kartal, Deniz Tuncel, Ozgur Bostanci
Inflammatory myofibroblastic tumor (IMT) histologically characterized by fibroblastic and myofibroblastic proliferation with inflammatory infiltrate. The therapy adopted was Whipple's pancreaticoduodenectomy with a histological diagnosis of the inflammatory myofibroblastic tumor. The disease that should be considered as the differential diagnosis is pancreatic cancer. The diagnosis and treatment of IMT is surgical resection.
December 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27924649/what-is-the-best-therapy-for-whipple-s-disease-our-point-of-view
#7
Federico Biagi, Gian Luigi Biagi, Gino Roberto Corazza
Although Whipple's disease (WD) has been treated with antibiotics since the early 50s, the best antibiotics and the duration of the therapy have not yet been established. We consider here the pro and cons of the two most commonly used therapies, ceftriaxone followed by trimethoprim-sulfamethoxazole (TMP-SMZ) and hydroxychloroquine in combination with doxycycline. The therapy based on ceftriaxone and TMP-SMZ is efficient in the vast majority of patients for the first few years. However, since reinfections or reactivations can occur, a life-long prophylaxis is necessary and doxycycline is nowadays the best option...
April 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27920655/deep-vein-thrombosis-as-initial-manifestation-of-whipple-disease
#8
Mônica Souza de Miranda Henriques, Alexandre Rolim da Paz, Ana Beatriz Person Gaertner, Cibelle Ingrid Stephen Melo, Priscyanne Lins Filgueiras, Rafaella Alencar Jerome
INTRODUCTION: Wipple disease (WD) is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as "stroke-like syndrome" or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27884091/whipple-s-disease
#9
Thomas Marth
In recent years, it has become apparent that Tropheryma whipplei not only causes a chronic multisystemic infection which is often preceded by arthropathies for many years, well known as 'classical' Whipple's disease, but also clinically becomes manifest with localized organ affections and acute (transient) infections in children. T. whipplei is found ubiquitously in the environment and colonizes in some healthy carriers. In this review, we highlight new aspects of this enigmatic infectious disorder.
December 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27882511/over-700-whipples-for-pancreaticobiliary-malignancies-postoperative-morbidity-is-an-additional-negative-prognostic-factor-for-distal-bile-duct-cancer
#10
Stefano Andrianello, Giovanni Marchegiani, Giuseppe Malleo, Borislav Chavdarov Rusev, Aldo Scarpa, Deborah Bonamini, Laura Maggino, Claudio Bassi, Roberto Salvia
BACKGROUND: Distal cholangiocarcinomas and pancreatic cancers both arise from pancreaticobiliary epithelium. Despite their common origin, there is a possible discrepancy in outcome. We analysed the surgical, pathological and survival outcome of resected distal cholangiocarcinoma compared with pancreatic cancer. METHODS: All cases of resected distal cholangiocarcinoma and pancreatic cancer from 1998 to 2014 were extracted from our database. Outcomes were compared...
November 23, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27864816/giant-insulinoma-report-of-a-case-and-review-of-published-reports
#11
Kazumitsu Ueda, Tetsuro Taira, Hiroyuki Hakoda, Shoko Nakata, Shinya Okata, Takeshi Nagai, Shigeo Aoki, Hideyuki Mishima, Akihiko Sako, Tsunehiko Maruyama, Minoru Okumura
BACKGROUND: Larger insulinomas are reportedly more likely to be malignant; however, their biological behavior has not been clearly elucidated. We here report the characteristics and treatment of a giant insulinoma with local invasion and lymph node metastasis. We also review published reports concerning the clinical features of giant insulinomas and comparing their grading with that of pancreatic neuroendocrine tumors. CASE PRESENTATION: A 71-year-old man was referred to our hospital for investigation of persistent hypoglycemia...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27855237/insulin-autoimmune-syndrome-a-rare-cause-of-postprandial-hypoglycemia
#12
Pooja Sahni, Nitin Trivedi, Abdulkadir Omer
: A 65-year-old obese Caucasian woman presented with symptomatic postprandial hypoglycemic episodes, resolution of symptoms with carbohydrate intake and significantly elevated anti-insulin antibody levels. She did not have any evidence for the use of oral antidiabetic medications, insulin, herbal substances, performing strenuous exercise or history of bariatric surgery. Fingerstick blood glucose readings revealed blood sugar of 35 mg/dL and 48 mg/dL, when she had these symptoms. Her medical history was significant for morbid obesity, hypothyroidism and gastro esophageal reflux disease...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27829601/whipple-s-disease-diagnosed-using-electron-microscopy-and-polymerase-chain-reaction
#13
Tomohiro Nagasue, Koichi Kurahara, Hiroki Yaita, Takahide Tanaka, Yumi Oshiro, Nobuaki Kuno, Akira Harada, Masashi Kameda, Kazuhide Iwasaki, Yutaka Tsutsumi
A 50-year-old man presented with bloody diarrhea and 25-kg weight loss over 3 months. Upper and lower endoscopy showed diffuse shaggy white villi in the duodenum and terminal ileum. In addition, capsule endoscopy and double-balloon enteroscopy revealed shaggy white villi in the entire small intestine. Histological examination of biopsy specimens found the lamina propria of the duodenal and intestinal mucosa to be densely infiltrated by rich foamy macrophages that were periodic acid-Schiff-positive. Electron microscopy showed numerous bacilli in the lamina propria...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27660822/endothelial-and-circulating-c19mc-micrornas-are-biomarkers-of-infantile-hemangioma
#14
Graham M Strub, Andrew L Kirsh, Mark E Whipple, Winston P Kuo, Rachel B Keller, Raj P Kapur, Mark W Majesky, Jonathan A Perkins
Infantile hemangioma (IH) is the most common vascular tumor of infancy, and it uniquely regresses in response to oral propranolol. MicroRNAs (miRNAs) have emerged as key regulators of vascular development and are dysregulated in many disease processes, but the role of miRNAs in IH growth has not been investigated. We report expression of C19MC, a primate-specific megacluster of miRNAs expressed in placenta with rare expression in postnatal tissues, in glucose transporter 1-expressing (GLUT-1-expressing) IH endothelial cells and in the plasma of children with IH...
September 8, 2016: JCI Insight
https://www.readbyqxmd.com/read/27647971/radical-nerve-dissection-for-the-carcinoma-of-head-of-pancreas-report-of-30-cases
#15
Qing Lin, Langping Tan, Yu Zhou, Quanbo Zhou, Rufu Chen
OBJECTIVE: To explore the clinical value of the radical nerve dissection (RND) for the carcinoma of head of pancreas (CHP). METHODS: The clinical and pathological data of 30 CHP patients who underwent RND in our hospital were retrospectively analyzed, with an attempt to explore the safety and short-term efficacy of this procedure. RESULTS: Among these 30 patients, the operative time was (351±61) min, the intra-operative blood loss was 350 (range, 300-600) mL, and the grades B and C pancreatic fistula was 23...
August 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/27636919/-malabsorption-is-a-leading-clinical-sign-of-small-bowel-disease
#16
A I Parfenov, L M Krums
The paper presents a variety of clinical manifestations of malabsorption syndrome (MAS) in celiac disease, collagenous sprue, Whipple's disease, Crohn's disease, intestinal lymphangiectasia, amyloidosis, common variable immune deficiency, and treatment of short bowel syndrome. It shows the specific features of the pathophysiology, diagnosis, and treatment of MAS in small bowel diseases.
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27593833/whipple-disease-confined-to-the-central-nervous-system-presenting-as-a-cystic-tumor-case-report-and-review-of-literature
#17
Mohamed Kilani, Leila Njim, Atef Ben Nsir, Mohamed Nejib Hattab
Although neurological features are commonly encountered in Whipple's disease (WD), presentation with purely neurologic patterns is uncommon. Exclusive confinement to the central nervous system (CNS) is extremely rare. In these cases, the development of isolated cerebral mass is exceptional. In the present paper, the authors describe a case of a 68-year-old man who presented with partial seizures. The neurological examination was normal. The imaging showed a cystic lesion. This tumor-like lesion was removed by performing frontal craniotomy...
May 5, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27588228/colon-mass-as-a-secondary-metastasis-from-cholangiocarcinoma-a-diagnostic-and-therapeutic-dilemma
#18
Azfar Niazi, Muhammad W Saif
Cholangiocarcinoma (bile ducts cancer) is a rare and aggressive form of cancer. It metastasizes frequently to liver, peritoneum, and lungs. Colon metastasis is extremely uncommon. We report here a 70-year-old male who was diagnosed with cholangiocarcinoma for which he underwent a Whipple procedure. Fifteen months later, a CT scan revealed mural thickening in the colon; this was supplemented with a PET scan, which confirmed this mass. Histological diagnosis of metastatic cholangiocarcinoma to the colon was made and the patient was treated with chemotherapy...
2016: Curēus
https://www.readbyqxmd.com/read/27519836/value-of-pelvis-ct-during-follow-up-of-patients-with-pancreatic-adenocarcinoma
#19
Jason J Bailey, James H Ellis, Matthew S Davenport, Richard H Cohan, Bin Nan, Aishwarya Parameswaran, Lin Hsu, Vaibhav Sahai, Isaac R Francis
PURPOSE: The purpose of this study was to determine the frequency in which the pelvis component of an abdominopelvic CT provides information that would influence clinical management in two separate groups of patients: those with previously resected pancreatic ductal adenocarcinoma (PDA) and those with locally advanced unresectable PDA. METHODS: This institutional review-board approved HIPAA compliant retrospective study with waived informed consent included 247 subjects with histologically proven PDA, including 153 subjects post-pancreaticoduodenectomy and 94 subjects with locally advanced unresectable disease...
January 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/27515528/psoas-abscess-secondary-to-retroperitoneal-distant-metastases-from-squamous-cell-carcinoma-of-the-cervix-with-thrombosis-of-the-inferior-vena-cava-and-duodenal-infiltration-treated-by-whipple-procedure-a-case-report-and-review-of-the-literature
#20
REVIEW
Matthias Mehdorn, Tim-Ole Petersen, Michael Bartels, Boris Jansen-Winkeln, Woubet Tefera Kassahun
BACKGROUND: Psoas abscess is a rare clinical disease of various origins. Most common causes include hematogenous spread of bacteria from a different primary source, spondylodiscitis or perforated intestinal organs. But rarely some abscesses are related to malignant metastatic disease. CASE PRESENTATION: In this case report we present the case of a patient with known squamous cell carcinoma of the cervix treated with radio-chemotherapy three years prior. She now presented with a psoas abscess and subsequent complete inferior vena cava thrombosis, as well as duodenal and vertebral infiltration...
August 11, 2016: BMC Surgery
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