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Published on August 1, 2011 | http://doi.org/10.5867/medwave.2011.08.5112

Pathophysiology, diagnosis and treatment of Whipple's disease

Fisiopatología, diagnóstico y tratamiento de la enfermedad de Whipple

Marco Gudiño Gomezjurado, Alvaro Gudiño Gomezjurado

Abstract

Whipple’s disease can involve any organ of the human economy thanks to the ability of the bacteria that causes it to evade the host immune system. Since its discovery to present the diagnosis and treatment have become a real challenge, though important, what it represents in the patient's prognosis. The aim of this paper is to review the pathogenesis, diagnostic and therapeutic options in the light of current evidence.

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Authors

Marco Gudiño Gomezjurado

Universidad Federal de Lavras, Lavras, Brasil.

Alvaro Gudiño Gomezjurado

Posgrado de Medicina Interna, Pontificia Universidad Católica del Ecuador, Puce, Ecuador
Hospital General Enrique Garcés, Quito, Ecuador.

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History

Citation Gudiño Gomezjurado M, Gudiño Gomezjurado A. Pathophysiology, diagnosis and treatment of Whipple's disease. Medwave 2011;11(08):e5112 doi: 10.5867/medwave.2011.08.5112

Submission date 11/06/2011

Acceptance date 21/07/2011

Publication date 01/08/2011

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Keywords

Whipple’s disease, physiopathology, therapeutics

Origin and peer review

con revisión externa por 3 revisores, a doble ciego

References

  1. Schneider T, Moos V, Loddenkemper C, Marth T, Fenollar F, Raoult D. Whipple's disease: new aspects of pathogenesis and treatment. Lancet Infect Dis. 2008 Mar;8(3):179-90. | CrossRef | PubMed
  2. Knaapen HK, Barrera P. Therapy for Whipple's disease. J Antimicrob Chemother. 2007 Sep;60(3):457-8. Epub 2007 Jul 10. | CrossRef | PubMed
  3. Boulos A, Rolain JM, Raoult D. Antibiotic susceptibility of Tropheryma whipplei in MRC5 cells. Antimicrob Agents Chemother. 2004 Mar;48(3):747-52. | CrossRef | PubMed
  4. Lagier JC, Lepidi H, Raoult D, Fenollar F. Systemic Tropheryma whipplei Clinical Presentation of 142 Patients with infections diagnosed or confirmed in a reference center. Medicine 2010; (89): 337-345. | CrossRef | PubMed
  5. Desnues B, Al Moussawi K, Fenollar F. New insights into Whipple’s disease and Tropheryma whipplei infections. Microbes and Infection 2010; (12) 1102-1110. | CrossRef | PubMed
  6. Lagier JC, Fenollar F, Lepidi H, Raoult D. Failure and relapse after treatment with trimethoprim/sulfamethoxazole in classic Whipple's disease. J Antimicrob Chemother. 2010 Sep;65(9):2005-12. | CrossRef | PubMed
  7. Feurle GE, Junga NS, Marth T. Efficacy of ceftriaxone or meropenem as initial therapies in Whipple's disease. Gastroenterology. 2010 Feb;138(2):478-86; quiz 11-2. Epub 2009 Oct 29. | CrossRef | PubMed
  8. Bonhomme CJ, Renesto P, Desnues B, Ghigo E, Lepidi H, Fourquet P, Fenollar F, Henrissat B, Mege JL, Raoult D. Tropheryma whipplei glycosylation in the pathophysiologic profile of Whipple's disease. J Infect Dis. 2009 Apr 1;199(7):1043-52. | CrossRef | PubMed
  9. Gorvel L, Al Moussawi K, Ghigo E, Capo C, Mege JL, Desnues B. Tropheryma whipplei, the Whipple’s disease bacillus, induces macrophage apoptosis through the extrinsic pathway. Cell Death Dis. 2010 Apr 8;1:e34. | CrossRef | PubMed
  10. Koligi K, Mertz D, Benz D, Vogt T, Bloemberg GV, Winter L, Tyndall A, Battegay M, Walker UA. Of bugs and joints : Oligoarthritis caused by Tropheryma whipplei. Internist (Berl). 2011 Jul;52(7):884-888. | CrossRef | PubMed
  11. Jackuliak P, Koller T, Baqi L, Plank L, Lasabova Z, Minarik G, Payer J. Whipple’s Disease Generalized Stage. Dig Dis Sci 2008; (53):3250–3258. | CrossRef | PubMed
  12. Fenollar F Mediannikov O, Socolovschi C, Bassene H, Diatta G, Herve R et al. Tropheryma whipplei bacteremia during fever in rural West Africa. Clinical Infectious Diseases 2010; (5):515–521. | CrossRef | PubMed
  13. Rolain JM, Fenollar F, Raoult D. False positive PCR detection of Tropheryma whipplei in the saliva of healthy people, BMC Microbiology 2007; (7):48. | CrossRef | PubMed
  14. Fenollar F, Laouira S, Lepidi H, Rolain JM, Raoult D. Value of Tropheryma whipplei Quantitative Polymerase Chain Reaction Assay for the Diagnosis of Whipple Disease: sefulness of Saliva and Stool Specimens for First-Line Screening Clinical Infectious Diseases 2008; (47):659–67. | CrossRef | PubMed
  15. Tran H. Reversible hypothyroidism and Whipple's disease, BMC Endocrine Disorders 2006; (6):3. | CrossRef | PubMed
  16. Hansen A, Mereles D. Cardiac complications in Whipple’s disease, European Journal of Echocardiography 2008; (9): 426–427. | CrossRef | PubMed
  17. Misbah SA, Ozols B, Franks A, Mapstone N. Whipple's disease without malabsorption: new atypical features. QJM. 1997 Dec;90(12):765-72. | PubMed
  18. Ratnaike R. Whipples disease. Postgrad Med J 2000;(76):760-766. | CrossRef | PubMed
  19. Maiwald M, Relman D. Whipple’s Disease and Tropheryma whippelii: Secrets Slowly Revealed. Clinical Infectious Diseases 2001; (32):457–63. | PubMed
  20. Panegyres PK, Edis R, Beaman M, Fallon M. Primary Whipple's disease of the brain: characterization of the clinical syndrome and molecular diagnosis. QJM. 2006 Sep;99(9):609-23. Epub 2006 Aug 11. | CrossRef | PubMed
  21. Müller C, Petermann D, Stain C, Riemer H, Vogelsang H, Schnider P, Zeiler K, Wrba F. Whipple's disease: comparison of histology with diagnosis based on polymerase chain reaction in four consecutive cases. Gut. 1997 Mar;40(3):425-7. | PubMed
  22. Knaapen HK, Barrera P. Therapy for Whipple's disease. J Antimicrob Chemother. 2007 Sep;60(3):457-8. Epub 2007 Jul 10. | CrossRef | PubMed
  23. Fredricks D, Relman D. Localization of Tropheryma whippelii rRNA in Tissues from Patients with Whipple?s Disease. The Journal of Infectious Diseases 2001;(183):1229?37. | CrossRef | PubMed
  24. La Scola B, Fenollar F, Fournier P, Altwegg M, Mallet M, Raoult D. Description of Tropheryma whipplei gen. nov sp. nov., the Whipple’s disease bacillus. International Journal of Systematic and Evolutionary Microbiology. 2001; (51): 1471–1479. | PubMed
  25. Panegyres P. Diagnosis and management of Whipples diasease of the brain. Pract Neurol 2008; (8): 311–317. | CrossRef | PubMed
  26. Maiwald M, Schuhmacher F, Ditton HJ, von Herbay A. Environmental occurrence of the Whipple's disease bacterium (Tropheryma whippelii). Appl Environ Microbiol. 1998 Feb;64(2):760-2. | PubMed
  27. Elkins C, Shuman T, Pirolo J. Cardiac Whipple’s disease without digestive symptoms. Ann Thorac Surg. 1999; (67):250–251. | CrossRef | PubMed
  28. Desnues B, Ihrig M, Raoult D, Mege JL. Whipple's disease: a macrophage disease. Clin Vaccine Immunol. 2006 Feb;13(2):170-8. | CrossRef | PubMed
  29. Kramer L, Manschot T, Barendregt J , Smit J. Whipple’s disease often a late diagnosis and a rare cause of nephropathy. NDT Plus 2009; (2): 55–58
  30. Fenollar F, Lepidi H, Raoult D, Whipple’s Endocarditis Review of the Literature and Comparisons with Q Fever Bartonella Infection, and Blood Culture–Positive Endocarditis. Clinical Infectious Diseases. 2001; (33): 1309–16. | CrossRef | PubMed
  31. Di Sabatino A, Vidali F, Cazzola P, Marchese A, Biancheri P, Biagi F, Corazza GR. Splenic hypofunction in Whipple's disease. Am J Gastroenterol. 2009 Oct;104(10):2641-3. | CrossRef | PubMed
  32. Mahnel R, Kalt A, Ring S, Stallmach A, Strober W, Marth T. Inmunosuppresive therapy in Whipples disease patients in associated with the appearance of gastrointestinal manifestations. Am J Gastroenterol. 2005; (100):1167-1173. | CrossRef | PubMed
  33. Fenollar F, Raoult D. Infection: How should classic Whipple disease be managed? Nat Rev Gastroenterol Hepatol. 2010 May;7(5):246-8. | CrossRef | PubMed
  34. Basagiannis C, Panagoulias G, Tentolouris N, Basoukeas S, Sambaziotis D, Spiros L. Whipple Disease. Southern Medical Journal. Apr 2010; (103): 353-356. | CrossRef | PubMed
  35. Panegyres P, Jonathan F, Fallon M, Connor C. The Amnesic Syndrome of Primary Whipple Disease of the Brain. Cog Behav Neurol. 2010; (23):49–51. | CrossRef | PubMed
  36. Freeman HJ. Tropheryma whipplei infection. World J Gastroenterol. 2009 May 7;15(17):2078-80. | CrossRef | PubMed
  37. Baisden B, Lepidi H, Raoult D, Argani P, Yardley JH, Dumler J. Diagnosis of Whipple Disease by Immunohistochemical Analysis. Am J Clin Pathol 2002; (118):742-748. | PubMed
  38. Desnues B, Raoult D, Mege JL. IL-16 Is Critical for Tropheryma whipplei Replication in Whipple’s Disease. J Immunol 2005;(175):4575-4582. | PubMed
  39. Moos V, Kunkel D, Marth T, Feurle GE, LaScola B, Ignatius R, Zeitz M, Schneider T. Reduced peripheral and mucosal Tropheryma whipplei-specific Th1 response in patients with Whipple's disease. J Immunol. 2006 Aug 1;177(3):2015-22. | PubMed
  40. Feurle GE, Moos V, Schinnerling K, Geelhaar A, Allers K, Biagi F, Bläker H, Moter A, Loddenkemper C, Jansen A, Schneider T. The immune reconstitution inflammatory syndrome in whipple disease: a cohort study. Ann Intern Med. 2010 Dec 7;153(11):710-7. | PubMed
  41. Dutly F, Altwegg M. Whipple's disease and "Tropheryma whippelii". Clin Microbiol Rev. 2001 Jul;14(3):561-83. | CrossRef | PubMed