Whipple's Disease: the First Japanese Case Diagnosed by Electron Microscopy and Polymerase Chain Reaction

Tatsuji, Yogi; Hokama, Akira; Kinjo, Fukunori; Tomiyama, Ryosaku; Koide, Michio; Kishimoto, Kazuto; Makishi, Tomoko; M, Oshiro; Miyagi, Satoru; Kobashigawa, Chiharu; Takaki, Ryo; Nakayama, Takashi; Saitô, Atsushi

doi:10.2169/internalmedicine.43.566

Cited by 18 publications

(10 citation statements)

References 12 publications

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“…whipplei such as classic Whipple’s disease or endocarditis have been scarcely reported in Asia and no such patients have been reported from Laos or adjoining North East Thailand [ 31 ]. To the best of our knowledge, only two Japanese patients and three individuals from India with Whipple's disease have been reported in the literature [ 31 , 32 ]. These data reinforces that although many people are exposed to T .…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Tropheryma whipplei in Lao Kindergarten Children

et al. 2015

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Background Tropheryma whipplei is a bacterium commonly found in feces of young children in Africa, but with no data from Asia. We estimated the prevalence of T. whipplei carriage in feces of children in Lao PDR (Laos).Methods/Principal FindingsUsing specific quantitative real-time PCR, followed by genotyping for each positive specimen, we estimated the prevalence of T. whipplei in 113 feces from 106 children in Vientiane, the Lao PDR (Laos). T. whipplei was detected in 48% (51/106) of children. Those aged ≤4 years were significantly less frequently positive (17/52, 33%) than older children (34/54, 63%; p< 0.001). Positive samples were genotyped. Eight genotypes were detected including 7 specific to Laos. Genotype 2, previously detected in Europe, was circulating (21% of positive children) in 2 kindergartens (Chompet and Akad). Genotypes 136 and 138 were specific to Chompet (21% and 15.8%, respectively) whereas genotype 139 was specific to Akad (10.55%).Conclusions/Significance T. whipplei is a widely distributed bacterium, highly prevalent in feces of healthy children in Laos. Further research is needed to identify the public health significance of this finding.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Tropheryma whipplei in Lao Kindergarten Children

et al. 2015

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“…Transmission electron microscopy revealed macrophages filled with phagocytosed rod‐shaped bacteria in various stages of degradation. These bacilli were morphologically consistent with T. whipplei (Fig. ).…”

Section: Case Reportmentioning

confidence: 56%

Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation

Vindigni

Taylor

Quilter

et al. 2016

Transplant Infectious Dis

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Whipple's disease (WD) is a rare infection caused by the bacterium Tropheryma whipplei that can affect multiple organs and most commonly occurs in the immunocompetent host. Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the first case of WD, to our knowledge, in a patient after liver transplantation with comorbid graft-versus-host-disease. We discuss the diagnostic challenges in this setting and the value of electron microscopy and in situ hybridization methods for confirming the infection. WD may be under-diagnosed in immunosuppressed transplant patients because the disease can present with atypical clinical and histological features that suggest other conditions.

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“…Most of the patients were in the fifth decade of life and presented with weight loss, diarrhea, fever and arthralgia. In three cases, the diagnosis of WD was confirmed on electron microscopy (8,9,11). In one case, the diagnosis was confirmed at autopsy.…”

Section: Discussionmentioning

confidence: 90%

“…Only five Japanese cases, including the current case, have been reported in the literature (Table) (8)(9)(10)(11). Nine additional cases were reported in the form of abstracts (12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

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Whipple Disease Diagnosed with PCR Using Formalin-fixed Paraffin-embedded Specimens of the Intestinal Mucosa

et al. 2013

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We herein present the case of a 54-year-old Japanese woman with Whipple disease diagnosed with polymerase chain reaction (PCR) using formalin-fixed paraffin-embedded (FFPE) specimens. The patient complained of weight loss, diarrhea and arthralgia. An endoscopic examination revealed swollen villi in the duodenum and ileum. Pathology demonstrated the presence of numerous macrophages filled with diastaseresistant PAS-positive particles. PCR using FFPE specimens amplified a fragment of 16S rDNA from Tropheryma whipplei. After the administration of ceftriaxone followed by trimethoprim/sulfamethoxazole, no signs of recurrence were observed for two years. The use of FFPE specimens for PCR should be considered for the prompt diagnosis and prevention of disease progression.

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Whipple's Disease: the First Japanese Case Diagnosed by Electron Microscopy and Polymerase Chain Reaction

Cited by 18 publications

References 12 publications

High Prevalence of Tropheryma whipplei in Lao Kindergarten Children

High Prevalence of Tropheryma whipplei in Lao Kindergarten Children

Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation

Whipple Disease Diagnosed with PCR Using Formalin-fixed Paraffin-embedded Specimens of the Intestinal Mucosa

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