Doença de Wipple - a propósito de um caso

Autores

  • Eugénia Santos Médica do Internato Complementar de Medicina Interna, Serviço de Medicina I, Hospital de Egas Moniz, Lisboa
  • Filipa Malheiro Médica do Internato Complementar de Medicina Interna, Serviço de Medicina I, Hospital de Egas Moniz, Lisboa
  • Ana Paula Vilas Médica do Internato Complementar de Medicina Interna, Serviço de Medicina I, Hospital de Egas Moniz, Lisboa
  • João Sequeira Assistente Hospitalar de Medicina Interna, Serviço de Medicina I, Hospital de Egas Moniz, Lisboa
  • Isabel Madruga Assistente Hospitalar de Medicina Interna, Serviço de Medicina I, Hospital de Egas Moniz, Lisboa
  • Pedro Abecasis Director do Serviço de Medicina I, Serviço de Medicina I, Hospital de Egas Moniz, Lisboa; Professor da Universidade Nova de Lisboa, Lisboa

Palavras-chave:

Whipple, Tropheryma whippelii, PCR, imunofluorescência, défice imunitário, reacção de Jarisch-Herxheimer

Resumo

Descreve-se um caso de doença de Whipple em que ocorreu uma reacção de Jarisch-Herxheimer. Obteve-se o diagnóstico pelo método clássico: a histologia. Discute-se, este caso à luz dos novos conhecimentos acerca da patogénese, diagnóstico,
tratamento e “follow-up” desta doença rara mas possivelmente fatal (se não tratada),
nomeadamente o défice imunitário e os novos métodos de diagnóstico como a técnica
de “polimerase chain reaction” (PCR) e o teste serológico (imunofluorescência).

Downloads

Não há dados estatísticos.

Referências

Relman DA, Schmidt TM, MacDermott RP, Falkow S. Identification of the uncultured bacillus of Whipple’s disease. N Engl J Med 1992; 327: 293-301.

Maiwald M, Schuhmacher F, Ditton H-J, Von Herbay A. Environmental occurrence of Whipple’s disease bacterium (Tropheryma whippelii). Appl Environ Microbiol 1998; 64 (2): 760-762.

Durand DV, Lecomte C, Cathebras P, Rousset H, Godeau P, SNFMI Research Group on Whipple disease. Whipple’s disease. Clinical review of 52 cases. Medicine 1997; 76: 170-184.

Southern JF, Moscicki RA, Magro C, Dickersin GR, Fallon JT, Bloch KJ. Lymphedema, limphocytic myocarditis and sarcoidlike granulomatosis-manifestations of Whipple’s disease. JAMA 1989; 261(10): 1467-1470.

Cho C, Linscheer WG, Hirschkorn MA, Ashutosh K. Sarcoidlike granulomas as an early manifestation of Whipple’s disease. Gastroenterology 1984; 87: 941-947.

Schoeden G, Goldenberger D, Forrer R, Gunz A, Dutly F, Hochli M, Altwegg M, Schaffner A. Deactivation of macrophages with IL-4 is the key to the isolation of Tropheryma whippelii. J Infect Dis 1997; 176: 672-677.

Raoult D, Birg ML, La Scola B, Fournier PE, Enea M, Lepidi H, Roux V, Piette JC, Vandenesh F, Durand DV, Marrie TJ. Cultivation of the bacillus of Whipple’s disease. N Engl J Med 2000; 342: 620-625.

Von Herbay A, Ditton H-J, Maiwald M. Diagnostic application of polymerase chain reaction assay for the Whipple’s disease bacterium to intestinal biopsies. Gastroenterology 1996; 110: 1735-1743.

Ramzan NN, Loftus Jr E, Burgart LJ, Rooney M, Batts KP, Wiesnar RH, Fredricks DN, Relman DA. Diagnosis and monitoring of Whipple’s disease by polymerase chain reaction. Ann Intern Med 1997; 126: 520-527.

Muller 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; 40: 425-427.

Von Herbay A, Ditton H-J, Schuhmacher F, Maiwald M. Whipple’s disease: staging and monitoring by cytology and polymerase chain reaction analysis of cerebrospinal fluid. Gastroenterology 1997; 113: 434-441.

Lynch T, Odel J, Fredrericks DN, Louis ED, Forman S, Rotterdam H, Fahn S, Relman DA. Polymerase chain reaction-based detection of Tropheryma whippelii in central nervous system Whipple’s disease. Ann Neurol 1997; 42: 120-124.

Muller C, Stain C, Burghuber O. Tropheryma whippelii in peripheral blood mononuclear cells and cells of pleural effusion. Lancet 1993; 341: 701.

Marth T, Fredricks D, Strober W, Relman DA. Limited role for PCR-based diagnosis of Whipple’s disease from peripheral blood mononuclear cells. Lancet 1996; 348: 66-67.

Lowsky R, Archer GL, Fyles G, Minden M, Curtis J, Messner H, Atkins H, Patterson B, Willey BM, McGeer A. Brief report: Diagnosis of Whipple’s disease by molecular analysis of peripheral blood. New Engl J Med 1994; 331: 1343-1346.

O’Duffy JD et al. Whipple’s arthritis: direct detection of Tropheryma whippelii in synovial fluid and tissue. Arthritis Rheum 1999; 42(4): 812-817.

Tasken K, Schulz T, Elgjo K, Skullerud K, Relman D, Brubakk O. Diagnostic utility of the polymerase chain reaction in two cases of suspected Whipple’s disease. Arch Intern Med 1998; 158: 801-803.

Gillin JS, Urmacher C, West R, Shike M. Disseminated Mycobacterium aviumintracellular infection in acquired immunodeficiency syndrome mimicking Whipple’s disease. Gastroenterology 1983;85:1187-1191.

Julie C, Rouveix E. Malakoplakie ou pseudo-maladie de Whipple? A propos d’un granulome bronquique chez un patient atteint du sida. Ann Pathol 1992; 12(1): 43-44.

Keinath RD, Merrel DE, Vlietstra R, Dobbins WO. Antibiotic treatment and relapse in Whipple’s disease. Long-term follow-up of 88 patients. Gastroenterology 1985; 88: 1867-1873.

Singer R. Diagnosis and treatment of Whipple’s disease. Drugs 1998; 55(5): 699-704.

Adler CH, Galetta SL. Oculo-facial-skeletal myorhytmia in Whipple’s disease: treatment with ceftriaxone. Annals of Internal Medicine 1990; 112: 467-469.

Cooper GS, Blades EW, Remler BF, Salata RA, Bennert KW, Jacobs GH. Central nervous system Whipple's disease: Relapse during therapy with trimethoprim-sulfamethoxazole and remission with cefixime. Gastroenterology 1994; 106: 782-786.

Marth T, Roux M, Von Herbay A, Meuer SC, Feurle GE. Persistent reduction of complement receptor 3 a-chain expressing mononuclear blood cells and transient inhibitory serum factors in Whipple’s disease. Clinical Immunology and Immunopathology 1994; 72(2): 217-226.

Playford RJ, Schulenburg, Herrington CS, Hodgson HJF. Whipple’s disease complicated by a retinal Jarish-Herxheimer reaction: a case report. Gut 1992; 33: 132-134.

Ficheiros Adicionais

Publicado

31-12-2002

Como Citar

1.
Santos E, Malheiro F, Vilas AP, Sequeira J, Madruga I, Abecasis P. Doença de Wipple - a propósito de um caso. RPMI [Internet]. 31 de Dezembro de 2002 [citado 19 de Junho de 2024];9(4). Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/1877

Edição

Secção

Casos Clínicos

Artigos mais lidos do(s) mesmo(s) autor(es)

<< < 1 2 3 > >>