Whipple's disease.

摘要: Whipple’s disease is a chronic systemic bacterial infection that predominantly affects middle-aged men. Antimicrobial therapy curative. The causative agent has been identified as Tropheryma whippelii. A PCR-based diagnostic test now available and particularly useful in patients with early-stage or atypical disease. can detect nucleic acids tissues body fluids, including joint fluid. Studies using this found no evidence T. whippelii may be common cause of unexplained seronegative oligoarthritis polyarthritis. Further work needed to identify the patient subsets most likely benefit from PCR testing specimens. Isolation organism achieved recently. This will probably allow development serological test, which facilitate diagnosis. Weight loss diarrhea are symptoms Joint manifestations antedate intestinal complaints three-fourths patients, mean interval being 6 years. In duodenal jejunal biopsy specimens contain macrophages filled PAS-stained granules corresponding bacteria. Nevertheless, some have symptoms, few normal histological findings. Before onset several clinical patterns should suggest Unexplained, chronic, polyarthritis affecting large limb joints presentation. characteristic feature intermittent occurrence manifestations, at least early Other destructive spondyloarthropathy. major advances made recently techniques for detecting isolating show more broader spectrum than was previously thought. Another hope diagnosis earlier, before potentially fatal complications.