Whipple’s disease: 5-year clinical follow-up

Abstract

The article presents a clinical observation of Whipple’s disease in a 42-year-old patient with a history of stage IIB Hodgkin’s lymphoma, in whom the disease debuted with articular syndrome, lymphadenopathy of the retroperitoneal and mesenteric lymph nodes, deep vein thrombosis of the leg. The diagnosis was confirmed by a morphological study of biopsy specimens of the duodenal mucosa, mesenteric lymph nodes 12 p. of the intestine, electron microscopic detection of accumulations of rod-shaped bacteria in the intestinal mucosa 6 years after the onset of clinical manifestations. Dynamic observation for 5 years was carried out using video gastroduodenoscopy, morphological assessment of changes in xanthoma macrophages proposed by A. Herbay, the percentage of damage by PAS-positive macrophages to the area of the lamina propria of the duodenal mucosa of the intestine. Conducted therapy with ceftriaxone for 14 days followed by taking co-trimaxosole for 4 years 7 months led to a stable remission.