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DOI: 10.1055/s-2004-814537
Refractory Whipple’s Disease with Anaemia: First Lessons from Capsule Endoscopy
Publication History
Submitted 16 May 2003
Accepted after Revision 9 November 2003
Publication Date:
09 July 2004 (online)
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Whipple’s disease is a chronic multisystem disorder caused by infection with the rod-shaped bacterium, Tropheryma whippelii. We report the case of a 65-year-old woman with intestinal Whipple’s disease that had been refractory to monotherapy with a number of antibiotics over a 2-year period. The patient then presented with watery diarrhoea, cachexia (body mass index 18 kg/m2) and chronic anaemia (haemoglobin 7.6 g/dl). Wireless capsule endoscopy showed that the disease affected the entire small intestine. Focal occult areas of bleeding were observed in different parts of the jejunum. The capsule’s transit time through the small intestine was 2 hours 43 minutes. Capsule endoscopy allows novel insights into the pathophysiology of Whipple’s disease.
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A. von Herbay, M. D
Pathologisches Institut · Universitätsklinikum
Im Neuenheimer Feld 220 · 69120 Heidelberg · Germany
Email: vonHerbay@WhipplesDisease.net