Authors:
Tünde Fischer Department of Medicine, Hospital of Zala County, Zalaegerszeg, Hungary
Zrínyi M. str. 1, H-8900, Zalaegerszeg, Hungary

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Márta Tiboly Department of Medicine, Hospital of Zala County, Zalaegerszeg, Hungary

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Péter Tóth Department of Medicine, Hospital of Zala County, Zalaegerszeg, Hungary

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Mária Szenes Department of Medicine, Hospital of Zala County, Zalaegerszeg, Hungary

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Zoltán VÖlgyi Department of Medicine, Hospital of Zala County, Zalaegerszeg, Hungary

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Otília Bali Department of Pathology, Hospital of Zala County, Zalaegerszeg, Hungary

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Beáta Gasztonyi Department of Medicine, Hospital of Zala County, Zalaegerszeg, Hungary

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Abstract

Whipple's disease is a chronic, systemic, relapsing bacterial illness, which always has a fatal outcome without treatment. It represents a significant diagnostic challenge for both clinicians and pathologists. In 80% of cases, the disease affects middle-aged white men belonging to the Caucasian race. Case report: The authors present three cases and review the aetiology, clinical features, presumed pathomechanism and the possibilities of treatment. Conclusion: Several immunologic mechanisms underlying Whipple's disease have emerged, but their primary or secondary nature has not yet been elucidated. First of all, this is a gastrointestinal disease; however, extraintestinal symptoms may often precede final diagnosis by several years. The histological hallmark for the diagnosis is the presence of numerous macrophages in the duodenal mucosa showing periodic acid — Schiff (PAS)-positive inclusions as well as polymerase chain reaction. The choice of antibiotics and the duration of therapy are empirical, but in most cases, there is an immediate response to the treatment. Relapses are common, particularly in patients with central nervous system involvement.

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  • [7]. G. Finzi F. Franzi C. Mastaglio et al.2007 Ultrastructural evidence of Tropheryma whipplei in PAS-negative granulomatosus lymph nodes Ultrastruct. Pathol. 31 169172.

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  • [8]. M. Papadopoulou M. Rentzos E. Vagiakis et al.2005 An unusual case of insomnia associated with Whipple encephalopathy: first case reported from Greece Neurol. Sci. 26 174177.

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  • [10]. Somogyi T. Szabó K. Pál et al.2004 Successful treatment of Whipple disease. The history of a patient with lymphnode enlargement (in Hungarian) LAM 14 676682.

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Clinical and Experimental Medical Journal
Language English
Size  
Year of
Foundation
2007
Publication
Programme
ceased
Volumes
per Year
 
Issues
per Year
 
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2060-6249 (Print)
ISSN 2060-968X (Online)

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