Whipple's disease
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Abstract
Objective: To recognize the clinical manifestations of Whipple's Disease (WD) as well as its diagnosis and clinical management. Bibliographic review: WD is a rare infection caused by the Tropheryma whipplei bacillus, which, as it is a commensal bacterium, is suspected to be associated with subtle genetic alterations in the individual. The progression of WD is slow and occurs over years, with initial symptoms related to weight loss, arthralgia and intestinal disorders. The initial nonspecific symptomatology is superimposed by severe cardiovascular, hepatic, neurological, cutaneous and rheumatological alterations in the more advanced stages. Biopsy of the small intestine using periodic acid-Schiff is the main diagnostic method, and the presence of the bacillus must be confirmed by polymerase chain reaction. Treatment with antibiotics for a prolonged period has shown good results in reducing symptoms and eradicating the bacteria, with the possibility of achieving a cure. Final considerations: WD is a multisystemic infection with several forms of clinical presentation and difficult diagnosis due to its low prevalence. Recognition of WD as a possible cause of clinical manifestations is fundamental for requesting specific diagnostic tests to detect the bacillus, and thus starting the correct treatment and follow-up.
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