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Endoscopy 2004; 36(7): 659-662
DOI: 10.1055/s-2004-814537
Case Report
© Georg Thieme Verlag Stuttgart · New York

Refractory Whipple’s Disease with Anaemia: First Lessons from Capsule Endoscopy

A.  Fritscher-Ravens1, 2 , C.  P.  Swain2 , A.  von Herbay3
  • 1Endoscopy Unit, St Mary’s Hospital, London, UK
  • 2Endoscopy Unit, Homerton University Hospital, London, UK
  • 3Institute of Pathology, University of Heidelberg, Heidelberg, Germany
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Publikationsverlauf

Submitted 16 May 2003

Accepted after Revision 9 November 2003

Publikationsdatum:
09. Juli 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