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Whipple's disease

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https://www.readbyqxmd.com/read/28439483/whipple-s-disease-manifested-as-recurrent-ascites
#1
Ali Aamar, Kamraan Madhani, Muhammad S Anwar, Prabhdeep Singh, Joel Garsten
Whipple's disease commonly presents as chronic diarrhea and abdominal pain. Ascites is an uncommon presentation of Whipple's disease. Here, we report a rare case of a 47-year-old male who presented with diarrhea and abdominal distention for three months. The physical examination was significant for ascites. Serum albumin was low and serum-to-ascites albumin gradient was < 1.1 g/dl. This suggested that ascites was less likely to be present due to portal hypertension. Enteroscopy showed erythematous duodenum and jejunum; biopsy was suggestive of periodic acid-Schiff stain (PAS) positive macrophages consistent with Whipple's disease...
March 21, 2017: Curēus
https://www.readbyqxmd.com/read/28385924/genotypic-analysis-of-tropheryma-whipplei-from-patients-with-whipple-disease-in-the-americas
#2
Dominique C Rollin, Christopher D Paddock, Bobbi S Pritt, Scott A Cunningham, Amy M Denison
Tropheryma whipplei, the agent of Whipple disease, causes a rare bacterial disease that may be fatal if not treated. The classical form of the disease includes diarrhoea, weight loss, arthritis, endocarditis and neurological manifestations. Genotyping studies done in Europe, Africa and Asia showed high genetic diversity with no correlation between genotypes and clinical features, but contributed to a better understanding of the epidemiology of the disease. More than 70 genotypes have been described. No similar assessment of T...
April 6, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28382437/diffuse-leptomeningeal-glioneuronal-tumor-dlgnt-mimicking-whipple-s-disease-a-case-report-and-literature-review
#3
Vega Karlowee, Manish Kolakshyapati, Vishwa Jeet Amatya, Takeshi Takayasu, Ryo Nosaka, Kazuhiko Sugiyama, Kaoru Kurisu, Fumiyuki Yamasaki
INTRODUCTION: Diffuse leptomeningeal glioneuronal tumor is a new entity under the neuronal and mixed neuronal-glial tumors in the WHO 2016 updated classification and commonly found in children and adolescents. The initial diagnosis is challenging because of its non-specific radiologic feature and negative CSF cytology analysis. A 17 years male was presented with intractable headache subsequently followed by back pain and joint pain. MRI showed enhancement of arachnoid membrane at basal cistern, bilateral sylvian fissure and cerebral cistern with slight enlargement of ventricles...
April 5, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28381450/management-of-endocrine-disease-pathogenesis-and-management-of-hypoglycemia
#4
Nana Esi Kittah, Adrian Vella
Glucose is the main substrate utilized by the brain and as such multiple regulatory mechanisms exist to maintain glucose concentrations. When these mechanisms fail or are defective hypoglycemia ensues. Due to these robust mechanisms hypoglycemia is uncommon and usually occurs in the setting of the treatment of diabetes using glucose- lowering agents such as sulfonylureas or insulin. The symptoms of hypoglycemia are non-specific and as such it is important to confirm hypoglycemia by establishing the presence of Whipple's triad prior to embarking on an evaluation for hypoglycemia...
April 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28325722/misdiagnosing-whipple-s-disease-in-the-young
#5
Danai Papakonstantinou, Michael J Riste, Gerald Langman, Ed Moran
Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease...
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28314316/non-whipple-operations-in-the-management-of-benign-premalignant-and-early-cancerous-duodenal-lesions
#6
Alexandros Papalampros, Demetrios Moris, Athanasios Petrou, Nikolaos Dimitrokallis, Ioannis Karavokyros, Dimitrios Schizas, Ioanna Delladetsima, Theodore N Pappas, Evangelos Felekouras
AIM: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions. PATIENTS AND METHODS: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed. RESULTS: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28298472/clinical-manifestations-treatment-and-diagnosis-of-tropheryma-whipplei-infections
#7
REVIEW
Ruben A V Dolmans, C H Edwin Boel, Miangela M Lacle, Johannes G Kusters
Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with Tropheryma whipplei, a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity...
April 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28293485/a-long-term-survivor-of-metastatic-pancreatic-adenocarcinoma-free-of-recurrence-12-years-after-treatment-of-oligometastatic-disease
#8
John M Stahl, Zenta Walther, Bryan W Chang, Howard S Hochster, Kimberly L Johung
Aggressive local therapy for patients with oligometastatic pancreatic ductal adenocarcinoma (PDAC) has traditionally not been pursued due to high rates of distant progression. We describe a 62-year-old male initially presenting with resectable PDAC who underwent the Whipple procedure but developed multiple liver metastases within two months of starting adjuvant gemcitabine. Oxaliplatin was added to the regimen and complete resolution of the liver lesions resulted. He remained disease-free for five years until re-staging revealed a small lung nodule...
February 2, 2017: Curēus
https://www.readbyqxmd.com/read/28281520/-whipple-s-disease-a-clinical-case-report
#9
L M Krums, N A Bodunova, E A Sabel'nikova, S G Khomeriki, K M Mirzoev, M S Sokolova, A I Parfenov
The paper describes a 56-year-old female patient who in December 2015 lost her appetite and 20 kg of weight, had diarrhea, rapidly increasing weakness, dizziness, joint pains, fever, swelling of the feet, and convulsions. Blood tests revealed anemia, elevated erythrocyte sedimentation rate, and hypoproteinemia. Computed tomography showed enlarged mesenteric and retroperitoneal lymph nodes. The doctor suspected lymphoma and referred her to the Moscow Clinical Research Center. The diagnosis of Whipple's disease was established by carrying out a small intestinal (duodenal) mucosal biopsy with the PAS reaction...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28275598/bilateral-ocular-myositis-associated-with-whipple-s-disease
#10
Vivak Parkash, Hardeep Singh Mudhar, Bart E Wagner, Didier Raoult, Ruth Batty, Hubert Lepidi, John Burke, Paul Collini, Thushan de Silva
PURPOSE: To describe the clinical features of a Caucasian female patient with a history of treated gastrointestinal Whipple's disease (WD) who developed new-onset diplopia, with a description of the histopathological features of the extraocular muscle biopsies. METHODS: A previously fit 38-year-old Caucasian female presented with acute-onset diplopia after being on a sustained medication regime for biopsy-proven gastrointestinal WD. A magnetic resonance imaging scan of her orbits with gadolinium revealed diffuse enhancement of the bellies of the extraocular muscles bilaterally, particularly the medial rectus, superior rectus, and superior oblique muscles, consistent with an infiltrative myositis...
January 2017: Ocular Oncology and Pathology
https://www.readbyqxmd.com/read/28268128/mr-imaging-of-adult-acute-infectious-encephalitis
#11
REVIEW
A Bertrand, D Leclercq, L Martinez-Almoyna, N Girard, J-P Stahl, T De-Broucker
BACKGROUND: Imaging is a key tool for the diagnosis of acute encephalitis. Brain CT scan must be urgently performed to rule out a brain lesion with mass effect that would contraindicate lumbar puncture. Brain MRI is less accessible than CT scan, but can provide crucial information with patients presenting with acute encephalitis. METHOD: We performed a literature review on PubMed on April 1, 2015 with the search terms "MRI" and "encephalitis". RESULTS: We first described the various brain MRI abnormalities associated with each pathogen of acute encephalitis (HSV, VZV, other viral agents targeting immunocompromised patients or travelers; tuberculosis, listeriosis, other less frequent bacterial agents)...
March 3, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28262041/acute-infections-caused-by-tropheryma-whipplei
#12
Jean-Christophe Lagier, Florence Fenollar, Didier Raoult
Tropheryma whipplei is the causative bacterium of Whipple's disease. Its first culture has led to an enlargement of the field of the caused infections. Here, we comprehensively review acute T. whipplei infections. In a cohort study featuring 4000 children, T. whipplei was significantly more common in patients with diarrhea (4%) than in those without (1.7%). A case-controlled study highlighted 58 patients suffering from pneumonia with the detection of T. whipplei in their bronchoalveolar fluids. Finally, a recent study detected T...
March 2017: Future Microbiology
https://www.readbyqxmd.com/read/28246510/normal-postoperative-computed-tomography-findings-after-a-variety-of-pancreatic-surgeries
#13
Ji Won Seo, Ho Kyoung Hwang, Minwook Lee, Ki Whang Kim, Chang Moo Kang, Myeong-Jin Kim, Yong Eun Chung
Pancreatic surgery remains the only curative treatment for pancreatic neoplasms, and plays an important role in the management of medically intractable diseases. Since the original Whipple operation in the 20th century, surgical techniques have advanced, resulting in decreased postoperative complications and better clinical outcomes. Normal postoperative imaging findings vary greatly depending on the surgical technique used. Radiologists are required to be familiar with the normal postoperative imaging findings, in order to distinguish from postoperative complications or tumor recurrence...
March 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28244025/-consensus-paper-treatment-of-acute-traveler-s-diarrhea-practice-recommendation-for-travel-advice
#14
Tomas Jelinek, Hans-Dieter Nothdurft, Martin Haditsch, Thomas Weinke
BACKGROUND: In times of mass tourism, traveler's diarrhea is one of the most common health problems of long-distance travel. Globally, some 40 million cases occur annually. Travellers to risk areas should therefore be comprehensively advised beforehand, as to what action to take in case of an acute traveler's diarrhea and what drugs to add to their first-aid kit. To date none, or hardly any specific studies or valid specific guidelines for the treatment of traveler's diarrhea are available for Germany...
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28230475/ultrastructural-changes-of-small-intestine-in-whipple-disease-patient
#15
Andres Piirsoo, Triin Remmel, Anu Kõiveer
No abstract text is available yet for this article.
January 2017: Ultrastructural Pathology
https://www.readbyqxmd.com/read/28190362/unusual-presentation-of-obstructive-jaundice
#16
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
#17
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
#18
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.
April 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
#19
REVIEW
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
#20
REVIEW
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...
April 2017: American Journal of Dermatopathology
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