PCR analysis in the pathological diagnosis of Whipple's disease: emphasis on extraintestinal involvement or atypical morphological features

Gras, Esther; MatiasâGuiu, Xavier; Garcia, Arnald; ArgÃ1⁄4elles, Rossmary; Espinosa, IÃ±igo; Sancho, Ferrán; Solà, Rosa; MartinezâAraque, Maria JosÃ©; Conde, J.; Teruel, Ana; Prat, Jaime

doi:10.1002/(sici)1096-9896(199907)188:3<318::aid-path352>3.3.co;2-5

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“…Cases of WD negative at bowel biopsies are documented [27]. The analysis of 16S rRNA or novel PCR methods on biopsies and samples is essential to confirm the diagnosis in WD or in other rare infectious diseases [7,28].…”

Section: Discussionmentioning

confidence: 99%

“…Histology showed aggregates of foamy periodic acid-Schiff positive and diastase-resistant histiocytes containing abundant cytoplasmatic granular material, compatible with Whipple's disease (WD). Analysis by polymerase chain reaction (PCR) of 16S rRNA of biopsy tissue confirmed the diagnosis [7]. Revision of the cervical lymph node biopsy performed in 2006 was also suggestive of WD.…”

Section: Case Reportmentioning

confidence: 93%

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Clinical pitfalls of leishmaniasis and Whipple’s disease hidden behind systemic lupus erythematosus: A case series

Losa

Firinu

Deidda

et al. 2019

AMicr

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Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that can affect major organs possibly leading to life-threatening complications and appears with heterogeneous clinical picture. SLE could present with broad spectrum of clinical and laboratory features that can resemble those of other diseases, such as hemopoietic malignancies, infections, or immune-mediated disorders. Its complexity and protean features overlap with many other diseases, hindering the differential diagnosis. Rarely, true overlap with other diseases may occur. Herein, we report a case series of two patients affected by infectious diseases, namely visceral leishmaniasis and Whipple's disease (WD), intertwined with clinical or serological features of SLE. In both cases, several confounding factors have led to a delay in the diagnosis. Moreover, we first describe the persistent elevation of autoantibodies and a monoclonal gammopathy in a patient with WD. Awareness of unusual presentations of infections or other rare disorders, which may be encountered in clinical practice when taking care of SLE patients, is essential for timely diagnosis and treatment of potentially lethal diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 93%