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Microscopy of the small intestine suggested Whipple's disease. To deepen diagnostics, mucosal samples of the small intestine were examined in the electron microscope, showing macrophages with the damaged mucosal membrane containing numerous elongated microorganisms corresponding structurally to Tropheryma whipplei (Figure 4).
Due to the low incidence of Whipple's disease and its difficult diagnosis, a patient's very detailed medical history, clinical examination, laboratory tests, endoscopic evaluation of the gastrointestinal tract and histopathological examination of mucosal bioptates should be regarded as basic in recognising this disease.
Altwegg, "Whipple's disease and "Tropheryma whippelii"," Clinical Microbiology Reviews, vol.
Raoult, "Whipple's disease: new aspects of pathogenesis and treatment," Lancet Infectious Diseases, vol.
From the negative results for malignancy, we proceeded to the investigation of Whipple's disease, as the patient's condition was progressively worsening.
Whipple's disease should be considered in the differential diagnosis of malignant tumours and lymphoproliferative diseases, as it manifests in the formation of multiple lymphadenopathy.
Nondeforming arthritis is most characteristic of Whipple's disease and is frequently the initial symptom.
In a large Spanish analysis of 91 cases of Whipple's disease from 1947 to 2001 [35], the most common symptoms and signs were weight loss (80%), diarrhoea (63%), lymphadenopathy (35%), skin signs (32%), abdominal pain (27%), fever (23%), joint complaints (20%), and neurological symptoms (16%).
Whipple's disease endocarditis following anti-TNF therapy for atypical rheumatoid arthritis.
Infective endocarditis as the only manifestation of Whipple's disease: an atypical presentation.
Identification of candidate antigen in Whipple's disease using a serological proteomic approach.
Im munosuppressive therapy in Whipple's disease patients is associated with the appearance of gastrointestinal manifestations.