Whipple's Disease: A Rare Cause of Malabsorption Syndrome

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Abstract

Introduction: Whipple's disease is a rare, chronic, systemic disease caused by the actinomycete Tropheryma whipplei. Clinical manifestations vary widely depending on the affected system, the most common being the digestive tract. Case Presentation: The authors report the case of a 52-year-old man with malabsorption syndrome, diarrhea, marked weight loss, melanoderma, and visual and proprioception disorders. Periodic acid-Schiff staining of a proximal small bowel biopsy and peripheral-blood PCR identification of T. whipplei confirmed the disease. The patient was initially treated with intravenous ceftriaxone, followed by oral trimethoprim/sulfamethoxazole with significant clinical improvement. Conclusions: This case is reported due to its rarity and the diagnostic challenge it presents. Although uncommon, Whipple's disease should be considered as a differential diagnosis of malabsorption syndrome due to its systemic impact and possible treatment with targeted antibiotic therapy.

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Cardoso, J., Gomes, L., Santos, S., Moreira, H., Gomes, P., Rua, J., & Fortuna, J. (2020). Whipple’s Disease: A Rare Cause of Malabsorption Syndrome. GE Portuguese Journal of Gastroenterology, 27(4), 283–289. https://doi.org/10.1159/000504760

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