Atypical Whipple’s disease with special endoscopic manifestations:A case report  

作　　者：Shuo Chen Yuan-Chen Zhou Shuang Si Hong-Yan Liu Qing-Rui Zhang Teng-Fei Yin Chu-Xi Xie Shu-KunYao Shi-Yu Du 

机构地区：[1]Department of Gastroenterology,China-Japan Friendship Hospital,Beijing 100029,China [2]Peking University China-Japan Friendship School of Clinical Medicine,Peking University,Beijing 100029,China [3]Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China [4]Department of Pathology,China-Japan Friendship Hospital,Beijing 100029,China [5]Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China

出　　处：《World Journal of Clinical Cases》2022年第35期13044-13051,共8页世界临床病例杂志

基　　金：The China-Japan Friendship Hospital Foundation,No.2019-1-QN-2.

摘　　要：BACKGROUND Whipple’s disease is a rare systemic infection caused by Tropheryma whipplei.Most patients present with nonspecific symptoms,and routine laboratory and imaging examination results also lack specificity.The diagnosis often relies on invasive manipulation,pathological examination,and molecular techniques.These difficulties in diagnosing Whipple’s disease often result in misdiagnosis and inappropriate treatments.CASE SUMMARY This paper reports on the case of a 58-year-old male patient who complained of fatigue and decreased exercise capacity.The results of routine blood tests indicated hypochromic microcytic anemia.Results of gastroscopy and capsule endoscopy showed multiple polypoid bulges distributed in the duodenal and proximal jejunum.A diagnosis of small intestinal adenomatosis was initially considered;hence,the Whipple procedure,a pylorus-preserving pancreaticoduodenectomy,was performed.Pathological manifestations showed many periodic acid-Schiff-positive macrophages aggregated in the intestinal mucosa of the duodenum,upper jejunum,and surrounding lymph nodes.Based on comprehensive analysis of symptoms,laboratory findings,and pathological manifestations,the patient was finally diagnosed with Whipple’s disease.After receiving 1 mo of antibiotic treatment,the fatigue and anemia were significantly improved.CONCLUSION This case presented with atypical gastrointestinal manifestations and small intestinal polypoid bulges,which provided new insight on the diagnosis of Whipple’s disease.

关 键 词：Whipple’s disease Whipple operation ENDOSCOPY Tropheryma whipplei PAS staining Intestinal polyposis Case report 

分 类 号：R589.2[医药卫生—内分泌]