| identification of the uncultured bacillus of whipple's disease. | whipple's disease is a systemic disorder known for 85 years to be associated with an uncultured, and therefore unidentified, bacillus. | 1992 | 1377787 |
| phylogeny of the whipple's-disease-associated bacterium. | efforts to culture and identify the intracellular bacteria associated with whipple's disease have been unsuccessful. nucleotide sequencing and amplification by the polymerase chain reaction was done on the bacterial 16 s ribosomal dna present in a small-bowel biopsy specimen taken from a patient with whipple's disease. a search by computer for similar rrna sequences filed in databases showed the whipple's-associated organism to be most similar to bacteria of the rhodococcus, streptomyces, and ar ... | 1991 | 1714530 |
| whipple's disease. | whipple's disease is a systemic bacterial infection that once was uniformly fatal and now is treatable with several different antibiotics in most cases. the exact nature of the whipple's bacillus is unknown, since the organism cannot consistently be cultured. there is also controversy concerning the role of immunologic dysfunction in patients with whipple's disease. in addition to the small intestine, whipple's disease can involve the remainder of the gastrointestinal tract, as well as the lymph ... | 1986 | 2417481 |
| electron microscopic detection of whipple's bacillus in sarcoidlike periodic acid-schiff-negative granulomas. | we describe a patient with whipple's disease without apparent intestinal involvement at initial presentation. electron microscopy demonstrated the typical bacilli in pas-negative lymph node and muscle biopsy specimens. | 1989 | 2467786 |
| whipple's bacillus. | | 1982 | 6176410 |
| mast cells in whipple's disease. | abundant degranulating mast cells were observed during an ultrastructural study of jejunal biopsy from an untreated patient with whipple's disease. some of these cells were observed in intimate contact with macrophages containing bacteria in various stages of disintegration. thereafter bacilli were often seen within the cytoplasm of mast cells, enclosed within vacuoles. these findings are suggestive of a cooperation between mast cell and macrophage in the defence of the organism against whipple' ... | 1982 | 6184484 |
| disseminated mycobacterium avium-intracellulare infection in acquired immunodeficiency syndrome mimicking whipple's disease. | we report a patient with acquired immunodeficiency syndrome whose clinical presentation and histologic features resembled whipple's disease. the unique feature of this case was the absence of whipple's bacillus and the presence of mycobacterium avium-intracellulare within macrophages infiltrating the small intestinal lamina propria. | 1983 | 6194041 |
| [detection of tropheryma whippelii using the polymerase chain reaction before and after therapy of whipple's disease]. | | 1994 | 7527318 |
| brief report: uveitis caused by tropheryma whippelii (whipple's bacillus) | | 1995 | 7529892 |
| [whipple disease: a single or multiple origin?]. | after having been considered as an essentially digestive disease, whipple's disease has appeared more and more to be a multivisceral disease with two main characteristics: on one hand whipple's disease yields a diffuse infiltration of tissues by abnormal macrophages without any other inflammatory reaction; on the other hand, aspects of microbial invasion by intra or extracellular unique rod-shaped gram+bacteria are found. this unusual pathological complex has alternatively been considered as sug ... | 1995 | 7534930 |
| [an elderly patient with arthralgia, fever, weakness and weight loss. diagnosis of whipple disease by pcr detection of tropheryma whippelii]. | | 1995 | 7536701 |
| tropheryma whippelii endocarditis confirmed by polymerase chain reaction. | this report concerns a patient with cardiac manifestation of whipple's disease. for the first time, the gene that encodes the 16s rrna of tropheryma whippelii was identified in a native aortic valve by means of a polymerase chain reaction technique. dna amplification gives evidence of tropheryma whippelii as a causative organism in infective endocarditis. | 1995 | 7540550 |
| detection of tropheryma whippelii dna in a patient with aids. | a case of an aids patient infected with the whipple's disease bacterium, tropheryma whippelii, is reported. a dna fragment with sequence specificity for the 16s rrna gene of the bacterium was detected by pcr in a duodenal biopsy specimen from a 55-year-old male patient with aids and diarrhea. the biopsy specimen contained periodic acid-schiff stain-positive macrophages which did not, however, resemble the sickleform-particle-containing cells characteristic of whipple's disease. this observation ... | 1995 | 7542271 |
| whipple's disease. | whipple's disease is a chronic systemic infectious disease caused by tropheryma whippelii that typically involves the small intestine and causes malabsorption. extraintestinal manifestations such as arthritis and fever are common and often exist prior to the onset of gastrointestinal symptoms. involvement of the central nervous system can occur and lead to permanent sequelae. weight loss, hyperpigmentation, and lymphadenopathy are frequent findings. the definitive diagnosis is made by biopsy of ... | 1995 | 7586631 |
| tropheryma whippelii in peripheral blood mononuclear cells and cells of pleural effusion. | | 1993 | 7680741 |
| whipple's disease with tubular aggregates in asymptomatic muscle. | a patient with whipple's disease aged 34 years is presented. at muscle biopsy, the patient presented with tubular aggregates of the quadriceps muscle. the patient did not exhibit any clinical and electromyographical indications of muscular involvement nor direct or indirect histological indications of muscular infiltration with whipple's bacillus. the possible etiopathogenetic factors creating these aggregates are discussed. | 1993 | 7682899 |
| [whipple's disease associated with opportunistic infections]. | a 36-year-old man, with a history of recurrent respiratory infection, dermatomycosis, arthralgia and abnormal stools for 12 years, developed a febrile illness (up to 40 degrees c). a serratia marcescens septicaemia responded to antibiotics. four months later cervical and abdominal lymph-adenopathies were noticed. cervical lymph node biopsy revealed lymphadenitis with epithelioid cell nests. duodenoscopy with biopsy demonstrated whipple's disease associated with lambliasis. electron-microscopy sh ... | 1993 | 7685263 |
| enteropathic arthritis, uveitis, whipple's disease, and miscellaneous spondyloarthropathies. | enteropathic arthritides, uveitis, and whipple's disease all belong to the category of spondyloarthropathies. the exact mechanism of relationships among joint, tendon, and axial involvement in the spondyloarthropathies, and gut and eye involvement, is unsolved. different hypotheses have been proposed to explain the role of enterogenic bacteria in interfering with the hla system and causing inflammatory reactions in these organs. the microorganism responsible for whipple's disease (tropheryma whi ... | 1993 | 7689329 |
| images in clinical medicine. tropheryma whippelii. | | 1996 | 8637538 |
| [2 cases of whipple disease with different outcomes]. | whipple's disease is a rare infectious disease with systemic manifestation on different organs. in 1992 the typical rod-shaped bacillus was identified as a gram-negative actinomycete with distinctive morphologic characteristics and named as tropheryma whippelii. the diagnosis is established by demonstrating the presence of pas-positive macrophages in the mucosa, with large cytoplasmatic granules. we present two cases of whipple's disease with different outcomes. both were treated with the same a ... | 1996 | 8701260 |
| prosthetic joint infection caused by tropheryma whippelii (whipple's bacillus). | | 1996 | 8852984 |
| whipple's disease. | whipple's disease (wd) is a rare systemic disease caused by infection with the recently identified actinomycetes, tropheryma whippelii. the disorder affects mostly middle-aged men, and the major clinical features are weight loss, arthropathy, and diarrhea; other symptoms, caused by systemic infection, are not infrequent. the diagnosis is usually established by duodenal biopsy, which shows the pathognomonic periodic acid schiff-positive infiltrates in the lamina propria. in addition, rt-polymeras ... | 1996 | 8903578 |
| spondylodiscitis caused by tropheryma whippelii. | we describe the first case of spondylodiscitis caused by tropheryma whippelii in which this so far unculturable organism was shown to be present at the site of infection in a patient without significant gastrointestinal symptoms. the methods used included broad-range pcr amplification with universal primers complementary to constant sequences of the gene coding for 16s rrna, direct sequencing of the amplified fragment, and comparison of the sequence determined with those deposited in sequence da ... | 1996 | 8927953 |
| diagnostic application of a polymerase chain reaction assay for the whipple's disease bacterium to intestinal biopsies. | the uncultured whipple's disease bacterium (tropheryma whippelii) was characterized in 1991-1992 by polymerase chain reaction (pcr) and sequencing of the bacterial 16s ribosomal rna gene. the aim of this study was to develop a pcr assay for diagnostic purposes. | 1996 | 8964398 |
| diagnosis and monitoring of whipple disease by polymerase chain reaction. | whipple disease is a chronic, multisystem disorder associated with infection with tropheryma whippelii, an organism that has not yet been grown on artificial media. in some cases, the diagnosis of whipple disease is uncertain if it is based on histology alone. although antibiotic regimens of various durations have been used, the disease recurs in about one third of cases. no test for cure is available. | 1997 | 9092317 |
| the syndrome of inappropriate antidiuretic hormone secretion in a patient with whipple's disease. | we report the case of a patient with central nervous system whipple's disease who developed the syndrome of inappropriate antidiuretic hormone secretion (siadh). the patient did not exhibit any gastrointestinal symptoms and initially was diagnosed based on neurologic findings and a duodenal biopsy that was positive for tropheryma whippelii by the polymerase chain reaction. radiologic involvement of the hypothalamus suggested whipple's disease as the likely etiology of the syndrome of inappropria ... | 1997 | 9099157 |
| strategy for detection and identification of bacteria based on 16s rrna genes in suspected cases of whipple's disease. | the 16s ribosomal rna (rrna) gene of the phylogenetic subdivision containing gram-positive bacteria with a high g + c content was detected specifically in clinical specimens from patients suspected of having whipple's disease. the primary structure of 16s rdna amplified from clinical samples was determined by cloning and sequencing. two sorts of sequences were identified: one corresponded exactly to the rrna sequence of tropheryma whippelii (genbank accession no. m87484) while the other was rela ... | 1997 | 9128199 |
| whipple's disease: comparison of histology with diagnosis based on polymerase chain reaction in four consecutive cases. | polymerase chain reaction (pcr) based detection of species specific sequences of the 16s rrna gene of tropheryma whippelii is a recently described method for diagnosis of whipple's disease. | 1997 | 9135536 |
| coinfection with tropheryma whippelii and a whipple's disease-associated bacterial organism detected in a patient with central nervous system whipple's disease. | | 1997 | 9163508 |
| whipple disease. clinical review of 52 cases. the snfmi research group on whipple disease. société nationale française de médecine interne. | whipple disease is a rare, multiorgan disease with prominent intestinal manifestations. we report a retrospective clinical study of 52 patients recruited in various parts of france from 1967 to 1994. seventy-three percent of the patients were male. clinical manifestations preceding the diagnosis were articular for 35 patients (67%), digestive for 8 patients (15%), general for 7 patients (14%), and neurologic for 2 patients (4%). at a later stage of the disease, 44 patients (85%) presented diarrh ... | 1997 | 9193452 |
| cerebral relapse of sarcoidlike whipple's disease. | whipple's disease, an infection with the recently identified intracellular bacillus tropheryma whippelii, is a systemic disorder that can be life threatening when untreated. in a few patients, the signs and symptoms of the disease are similar to those of sarcoidosis, and this illness is referred to as sarcoidlike whipple's disease. this variant must be recognized because patients with sarcoidlike whipple's disease must be treated with antibiotics instead of corticosteroids, which would be indica ... | 1997 | 9195094 |
| myocarditis in whipple's disease: an unsuspected cause of symptoms and sudden death. | whipple's disease (wd) is an uncommonly diagnosed infection caused by the recently characterized bacillus, tropheryma whippelii. the association of wd with pericarditis and endocarditis is widely recognized, although less attention has been paid to the myocardium as a site of disease. although the disease was uniformly fatal before antibiotic therapy, current treatment usually results in cure. we report two patients whose deaths were directly related to cardiac involvement by wd and whose underl ... | 1997 | 9195567 |
| polymerase chain reaction-based detection of tropheryma whippelii in central nervous system whipple's disease. | whipple's disease of the central nervous system (cns) may be associated with normal intestinal histology as a result of minimal or patchy involvement. the diagnosis is difficult and is frequently made post mortem. we studied 6 patients with clinically suspected cns whipple's disease; 2 had oculomasticatury myorhythmia (omm) fitting criteria for a diagnosis of definite cns whipple's disease. one of the 2 had duodenal histology highly suggestive of whipple's disease the other 5 patients had normal ... | 1997 | 9225695 |
| deactivation of macrophages with interleukin-4 is the key to the isolation of tropheryma whippelii. | whipple's disease is a systemic illness caused by a specific agent. despite recognition of bacteria in lesions, efforts to isolate the causative agent remained futile. a novel strategy was devised to culture whipple bacilli in deactivated mononuclear phagocytes. infected tissue was inoculated into human phagocytes deactivated with interleukin (il)-4, il-10, and dexamethasone. within 8-10 days, diastase-resistant periodic acid-schiff-positive inclusions appeared, corresponding to intact and degen ... | 1997 | 9291314 |
| [whipple's disease: molecular biology--clinical aspects--therapy]. | whipple's disease is a rare systemic bacterial disease, affecting mostly middle-aged white men. its clinical presentation is very variable. arthralgias, fever of unknown origin or central nervous system symptoms may precede the more typical gastrointestinal manifestations with weight loss and chronic diarrhea. the diagnosis is based on the histopathologic demonstration of pas-positive macrophages in duodenal or jejunal biopsies. in addition, it has become possible to detect the causative actinob ... | 1997 | 9333910 |
| molecular diagnosis of bacterial endocarditis by broad-range pcr amplification and direct sequencing. | broad-range pcr amplification of part of the 16s rrna gene followed by single-strand sequencing was applied to samples of 18 resected heart valves from patients with infective endocarditis. the pcr results were compared with those of cultures of valves and with those of previous blood cultures. for two patients there was agreement with the cultures of the valves; for nine patients there was agreement with the previous blood cultures, which were positive, while the cultures of the valves were neg ... | 1997 | 9350723 |
| molecular evidence and clinical significance of herpesvirus coinfection in the central nervous system. | a total of 60 cerebrospinal fluid (csf) specimens from patients manifesting symptoms resembling viral central nervous system (cns) disease were examined for the presence of herpes simplex virus (hsv), human herpesvirus 6 (hhv-6), epstein-barr virus (ebv), cytomegalovirus, varicella-zoster virus, borrelia burgdorferi, and tropheryma whippelii dna by pcr. of 30 specimens which were selected on the basis of hsv dna positivity, 2 were concomitantly positive for hhv-6 dna and 1 was positive for ebv d ... | 1997 | 9350749 |
| invasion and destruction of mucosal plasma cells by tropheryma whippelii. | whipple's disease is a poorly understood systemic disorder associated with the bacillus, tropheryma whippelii. an early stage of whipple's disease is studied by using electron microscopy (elmi) and immunohistochemistry. the diagnosis was confirmed by polymerase chain reaction-amplification and sequencing of the 16s ribosomal-rna of the bacterium. by using elmi, tropheryma whippelii was found in plasma cells and macrophages in the jejunal mucosa. the immunoglobulin (ig)a-positive plasma cells wer ... | 1997 | 9416701 |
| environmental occurrence of the whipple's disease bacterium (tropheryma whippelii). | whipple's disease is a systemic disorder in which a gram-positive rod-shaped bacterium is constantly present in infected tissues. after numerous unsuccessful attempts to culture this bacterium, it was eventually characterized by 16s rrna gene analysis to be a member of the actinomycetes. the name tropheryma whippelii was proposed. until now, the bacterium has only been found in infected human tissues, but there is no evidence for human-to-human transmission. here we report the detection of dna s ... | 1998 | 9464419 |
| ultrastructural localization of osteopontin immunoreactivity in phagolysosomes and secretory granules of cells in human intestine. | a post-embedding ultrastructural immunogold method was used to detect osteopontin in human intestinal biopsies with special emphasis on secretory and phagocytic organelles. osteopontin immunoreactivity was localized to phagolysosomes of macrophages, fibroblasts, absorptive epithelial cells of the small intestine and paneth cells. the mucigen secretory granules and golgi structures of mucous epithelial cells of the small intestinal epithelium contained osteopontin, but secretory granules of numer ... | 1997 | 9466147 |
| whipple's disease without malabsorption: new atypical features. | the diagnosis of whipple's disease in the absence of intestinal involvement is difficult and often overlooked. we describe five patients aged 8-71 years with normal jejunal biopsies and disparate clinical features, previously unrecognized in whipple's; all were investigated at a single institution over a period of 18 months. routine histological examination for periodic acid-schiff (pas) positive macrophages and polymerase chain reaction (pcr) analysis for tropheryma whippelii was performed on t ... | 1997 | 9536341 |
| diagnostic utility of the polymerase chain reaction in 2 cases of suspected whipple disease. | we describe 2 patients with a diagnosis of whipple disease in whom the usual antibiotic therapy failed. a polymerase chain reaction-based test was used to identify the recently described whipple bacillus, tropheryma whippelii. in one case, the diagnosis was confirmed, whereas in the second case, which had been histologically diagnosed as whipple disease of the brain, the process was identified as a monocyte-derived histiocytosis. in conclusion, whipple disease can be distinguished from other dis ... | 1998 | 9554687 |
| diagnosis and treatment of whipple's disease. | whipple's disease is a rare systemic infectious disease. to date, it has neither been possible to culture the bacillus tropheryma whippelii, nor to infect other individuals with the pathogen. today the diagnosis is confirmed by means of polymerase chain reaction (pcr) technology. typically, the material for the pcr analysis comes from the duodenum. the diagnosis can also be established in this way on the basis of other tissue, or the cerebrospinal fluid. treatment should only be carried out with ... | 1998 | 9585865 |
| whipple's disease with aortic regurgitation requiring aortic valve replacement. | cardiac involvement in whipple's disease is well established. however, clinical consequences beside antibiotic therapy have rarely been reported. our observation of a middle-aged man with increasing dyspnea, fatigue, chest pain, and dizziness leading to admission to a cardiology department demonstrates that cardiac symptoms may represent the main symptoms in patients with whipple's disease. the diagnosis was not made prior to upper endoscopy, performed because of diarrhea, and revealed whipple's ... | 1998 | 9646112 |
| whipple disease presenting as posterior uveitis without prominent gastrointestinal symptoms. | to describe the clinical presentation and course of whipple disease in an adult. | 1998 | 9683160 |
| pcr analysis of t. whippelii dna in a case of whipple's disease: effect of antibiotics and correlation with histology. | a 58-yr-old man developed severe weight loss, arthralgias, and diarrhea. endoscopic examination of the stomach and duodenum revealed thickened folds of duodenal mucosa. biopsy of the gastric mucosa was negative, whereas duodenal biopsy revealed blunted epithelial villi and pas-positive foamy macrophages within the lamina propria. bacilli typical of those associated with whipple's disease were found by electron microscopy. the diagnosis was confirmed by polymerase chain reaction (pcr) assay, whic ... | 1998 | 9732952 |
| ocular manifestations of whipple disease: an atypical presentation. | a 62-year-old man developed bilateral granulomatous iridocyclitis after uncomplicated cataract surgery. on ophthalmic examination, we found moderate inflammation in the anterior chamber and vitreous, with granular crystalline deposits on the iris, intraocular lens, and capsular bag. biopsy of the lens capsule and vitreous revealed periodic acid-schiff-positive, diastase-resistant bacilli consistent with tropheryma whippelii. electron microscopy and polymerase chain reaction confirmed the diagnos ... | 1998 | 9747687 |
| whipple's syndrome (uveitis, b27-negative spondylarthropathy, meningitis, and lymphadenopathy) associated with arthrobacter sp. infection. | to report an unusual case of whipple's disease, including uveitis, seronegative spondylarthropathy, meningitis, and lymphadenopathy, associated with an arthrobacter sp. infection. | 1998 | 9787360 |
| abdominal lymphomas, convulsive seizure and coma: a case of successfully treated, advanced whipple's disease with cerebral involvement. | whipple's disease is a rare, generalized inflammatory disorder due to the recently described bacterium tropheryma whippelii. we report an unusual, successfully treated case of a 32-year-old woman, who presented with a 25 month history of large abdominal lymphomas, polyserositis and cachexia. the diagnosis of whipple's disease was confirmed by duodenoscopy, lymph node and duodenal histology and polymerase chain reaction analysis of biopsy material and cerebrospinal fluid. a prolonged convulsive s ... | 1998 | 9831415 |
| homogeneity of 16s-23s ribosomal intergenic spacer regions of tropheryma whippelii in swiss patients with whipple's disease. | the current genetic strategies used to identify tropheryma whippelii, the putative agent of whipple's disease, are based on pcr-mediated amplification of a part of its 16s rrna gene (16s rdna). because there is very little intraspecies variation in these molecules, they are not suitable as targets for epidemiologic investigations. however, the intergenic spacer region between the 16s and 23s rdnas is usually much more variable and has repeatedly been used for epidemiologic purposes. we have ther ... | 1999 | 9854081 |
| whipple's disease. | whipple's disease is a chronic, multisystem disease that is caused by tropheryma whippelii infection. more information is now known about this unusual infectious process, which was once considered uniformly fatal. immunologic, diagnostic, and therapeutic advancements are reviewed in this article. hopefully, future advances in the basic and clinical sciences will lead to a more rapid diagnosis, more complete understanding of the effects of infection, improved therapy, and better clinical outcome. | 1998 | 9891703 |
| rheumatologic manifestations of gastrointestinal disorders. | there are many different rheumatic symptoms of gastrointestinal (gi) disorders and a whole range of gi symptoms that occur in rheumatologic disorders. spondyloarthropathies (spa) are closely related to the gi tract. bacterial dna has been detected in peripheral but not the sacroiliac joints of patients, including enterobacteria; the significance of this finding is not clear yet because antibiotic therapy seems not to be effective. the synovial lymphocyte proliferation of reactive arthritis (rea) ... | 1999 | 9894633 |
| a rare case of aortic valve endocarditis caused by tropheryma whippelii with left coronary cusp perforation diagnosed by transoesophageal echocardiography and pcr. | | 1999 | 9922364 |
| detection of tropheryma whippelii dna (whipple's disease) in faeces. | to date the diagnosis of whipple's disease is based mainly on the histopathological analysis of duodenal biopsies since tropheryma whippelii cannot be cultured in vitro. we investigated the possibility to diagnose whipple's disease by detection of bacterial dna in faces. nested polymerase chain reaction with amplification of part of the 16s rrna gene of this bacterium in dna extracted from faeces of a patient with whipple's disease was performed. sequencing of the polymerase chain reaction produ ... | 1999 | 10091107 |
| [tropheryma whippelii, an emerging intracellular pathogen causing whipple disease]. | clinical diagnosis: whipple's disease is a diffuse disease with a wide variety of clinical manifestations. differential diagnoses include chronic enteritis, chronic joint disease, chronic meningoencephalitis and prolonged fever with weight loss, chronic uveitis and endocarditis with negative blood culture. molecular diagnosis: histologically the characteristic lesions contain pas-positive inclusions. pcr of rnar gene 16s in fresh tissue identifies tropheryma whippelii and confirms bacteriologica ... | 1999 | 10093605 |
| diagnosis and follow-up of whipple's disease by amplification of the 16s rrna gene of tropheryma whippelii. | amplification of the 16s rrna gene of tropheryma whippelii was performed in eight patients with whipple's disease and 34 control patients to confirm a diagnosis of whipple's disease and to monitor the course of disease. polymerase chain reaction (pcr) tests were positive before treatment in 13 of 15 tissue samples from whipple's disease patients (gut 8/8; lymph nodes 2/2; bone marrow 1/2; peripheral blood 2/3), in contrast to none of 54 tissue samples from controls. pcr tests converted to negati ... | 1999 | 10192717 |
| anonymous survey of blood donors by polymerase chain reaction for tropheryma whippelii. | | 1999 | 10209674 |
| whipple's arthritis: direct detection of tropheryma whippelii in synovial fluid and tissue. | we describe 2 patients presenting with polyarthritis in whom the synovial fluid (1 patient) or synovial tissue (1 patient) was positive for tropheryma whippelii, the whipple's disease-associated bacillus, when examined by polymerase chain reaction (pcr) and dna sequencing. histopathologic findings were consistent with articular whipple's disease in the synovial fluid of 1 patient and the synovial tissue of the other. in both patients, bowel mucosal specimens were negative for whipple's disease f ... | 1999 | 10211899 |
| [whipple's disease]. | whipple's disease is characterized by malabsorption, weight loss, diarrhoea and abdominal pain, often preceded by a long period of migrating arthralgias. instead of the intestine the heart, brain, eyes, lungs or blood vessels may be affected. whipple's disease is caused by tropheryma whippelii, a bacillus found inside phagocytes. a specific defect in the immune system of the host appears to play a part. the diagnosis is based on microscopic examination of periodic-acid-schiff(pas)-stained slides ... | 1999 | 10221107 |
| [whipple's disease in a man with weight loss and diarrhea]. | in a 45-year-old man with diarrhoea, upper abdominal pain and malabsorption whipple's disease was diagnosed by gastroduodenoscopy with small bowel biopsies. the disease is rare and can present with gastrointestinal problems but also with cardiac or neurological complaints. tropheryma whippelii, the aetiological organism, can be demonstrated by pathological investigation of biopsies and with the polymerase chain reaction (pcr). treatment with trimethoprim-sulfamethoxazole 160-800 mg twice daily i ... | 1999 | 10221112 |
| pcr-positive tests for tropheryma whippelii in patients without whipple's disease. | | 1999 | 10392994 |
| whipple endocarditis without overt gastrointestinal disease: report of four cases. | cardiac manifestations of whipple disease are rarely diagnosed before death. | 1999 | 10419427 |
| pcr analysis in the pathological diagnosis of whipple's disease: emphasis on extraintestinal involvement or atypical morphological features. | pcr analysis of species-specific bacterial 16s rrna gene of tropheryma whippelii was performed in biopsies from 10 cases of whipple's disease (wd). in seven patients showing the typical clinical picture of wd, pcr was performed on the diagnostic intestinal biopsy. in the remaining three cases (an autopsy case of disseminated wd and two patients showing lymphadenopathy as the initial clinical presentation), pcr was done on lymph node specimens. in one of the lymph node biopsies, an unusual sarcoi ... | 1999 | 10419602 |
| relapsing whipple's disease presenting with hypopituitarism. | a 44-year-old man with a history of whipple's disease 8 years ago presented with recurrent grand mal seizures and signs of hypopituitarism on physical examination. magnetic resonance imaging of the brain revealed a hypothalamic lesion of 1 cm diameter in the region of the rostral infundibulum. hypopituitarism was confirmed by low levels of serum cortisol, free testosterone and free thyroxine without an elevated tsh. whipple encephalitis with hypothalamic involvement was suggested and verified by ... | 1999 | 10435068 |
| tropheryma whippelii dna in saliva of healthy people. | in a random sample of 40 healthy people, 35% showed evidence of tropheryma whippelii dna in their saliva. consistent detection of t. whippelii dna on repeated sampling suggests that this organism can be an oral commensal. | 1999 | 10513716 |
| hypertrophic osteoarthropathy can indicate recurrence of whipple's disease. | we report the case of a patient with whipple's disease (wd) who developed hypertrophic osteoarthropathy (hoa) characterized by digital clubbing, periostosis of the tubular bones, and polysynovitis. the hoa disclosed the recurrence of the patient's wd, since polymerase chain reaction (pcr) analysis clearly demonstrated the presence of tropheryma whippelii in the synovial fluid from the patient's left knee. initiation of appropriate antibiotic therapy resulted in complete healing of all clinical r ... | 1999 | 10513818 |
| polymerase chain reaction analysis for diagnosis of tropheryma whippelii infective endocarditis in two patients with no previous evidence of whipple's disease. | | 1999 | 10525255 |
| pcr for tropheryma whippelii. | | 1999 | 10543701 |
| tropheryma whippelii in synovial tissue and fluid. | | 1999 | 10577317 |
| [the hypothesis of infectious etiology for idiopathic nervous system diseases: from the postulates of koch to the criteria of hill]. | the evaluation of the hypothesis of an infectious etiology to some neurological diseases comprises four different situations. first, numerous neurological diseases have an obvious infectious etiology (encephilitis, meningoencephilitis). second, some neurological disorders were primarily suspected to be have an infectious etiology, but the causative microorganism was discovered either longtime after the princeps description of the disease (neurologic whipple disease, due to tropheryma whippelii), ... | 1999 | 10598368 |
| evaluation of a specific nested pcr targeting domain iii of the 23s rrna gene of "tropheryma whippelii" and proposal of a classification system for its molecular variants. | "tropheryma whippelii"-associated infections are usually confirmed histopathologically by using light microscopy. pcr assays targeting the 16s rrna gene (16s rdna) of "t. whippelii" are increasingly being applied for this purpose. compared to microscopic analysis, pcr seems to be more sensitive, as indicated by the fact that several cases of whipple's disease with negative histopathological findings but positive pcr results have been reported. considering the lack of pathognomonic clinical featu ... | 2000 | 10655352 |
| dermatomyositis and whipple's disease. | a 14-year-old boy presented with a 3-year history of a skin rash typical of juvenile dermatomyositis, and a 2-month history of mild proximal weakness, myalgia, and weight loss. a quadriceps biopsy showed perifascicular fibre atrophy, focal necrosis and regeneration, immunohistochemical labelling for hla-1 on the surface of the fibres, and focal c5-9 deposition in capillaries. macrophages with diastase-resistant, pas-positive cytoplasm were present. ultrastructural studies showed electron dense a ... | 2000 | 10677863 |
| cultivation of the bacillus of whipple's disease. | whipple's disease is a systemic bacterial infection, but to date no isolate of the bacterium has been established in subculture, and no strain of this bacterium has been available for study. | 2000 | 10699161 |
| organization, structure, and variability of the rrna operon of the whipple's disease bacterium (tropheryma whippelii). | whipple's disease is a systemic disorder associated with a cultivation-resistant, poorly characterized actinomycete, tropheryma whippelii. we determined a nearly complete rrna operon sequence of t. whippelii from specimens from 3 patients with whipple's disease, as well as partial operon sequences from 43 patients. variability was observed in the 16s-23s rrna spacer sequences, leading to the description of five distinct sequence types. one specimen contained two spacer sequence types, raising th ... | 2000 | 10809715 |
| microbial pathogens with impaired ability to acquire host iron. | successful microbial pathogens must be adept in obtaining growth-essential iron from healthy hosts. some potential pathogens, however, are sufficiently impaired in iron acquisition ability so as to be dangerous mainly in hosts with such iron loading conditions as alcoholism, asplenia, hemochromatosis, beta-thalassemia major, or tobacco smoking. the association of six impaired pathogens (capnocytophaga canimorsis, yersinia enterocolitica and y. pseudotuberculosis, vibrio vulnificus, tropheryma wh ... | 2000 | 10831229 |
| cloning and sequencing of a part of the heat shock protein 65 gene (hsp65) of "tropheryma whippelii" and its use for detection of "t. whippelii" in clinical specimens by pcr. | using broad-spectrum primers, we have amplified, cloned, and sequenced a 620-bp fragment of the "tropheryma whippelii" heat shock protein 65 gene (hsp65) from the heart valve of a patient with whipple's endocarditis. the deduced amino acid sequence shows high similarity to those from actinobacteria, confirming that "t. whippelii" is indeed a member of this phylum. based on the nucleotide sequence, we have developed a "t. whippelii"-specific seminested pcr. seventeen patients shown to be positive ... | 2000 | 10834984 |
| whipple's disease with isolated central nervous system symptomatology diagnosed by molecular identification of tropheryma whippelii in peripheral blood. | we report a new case of whipple's disease (wd) confined to the central nervous system. the patient presented with ataxia, ophthalmoplegia, hypersomnia, hemiparesis and generalized myorhythmia. the diagnosis was confirmed by identification of specific sequences of the causal agent of wd, the actinobacteria tropheryma whippelii (tw), by pcr of dna extracted from peripheral blood. an epidemiological survey of tw in patients with dementia suggests that wd is an uncommon cause of dementia in our popu ... | 2000 | 10846886 |
| an uncommon cause of recurrent strokes: tropheryma whippelii endocarditis. | cardiac involvement in whipple's disease is not an uncommon phenomenon in autopsies, but its clinical occurrence is often overshadowed by gastrointestinal symptoms. we report a very atypical manifestation of this disorder. | 2000 | 10926970 |
| tropheryma whippelii dna in saliva of patients without whipple's disease. | tropheryma whippelii is the causative agent of whipple's disease, a difficult to diagnose systemic illness. amplification of part of its 16s ribosomal rna gene(s) has become a standard diagnostic method because of increased sensitivity as compared to classical histopathological analysis. recently, we demonstrated the presence of t. whippelii dna by pcr in duodenal biopsies and/or gastric juice of a considerable fraction of individuals without clinical signs of whipple's disease. in this follow-u ... | 2000 | 10961527 |
| toward a new understanding of whipple's disease. | since the first successful antibiotic treatment of whipple's disease in 1952, many breakthroughs have occurred in the diagnosis and treatment of this disease that was once thought fatal. this article provides a historic overview and highlights recent encouraging discoveries regarding this underdiagnosed disease, including the use of polymerase chain reaction techniques and the recent cultivation of the tropheryma whippelii bacterium. | 2000 | 10981027 |
| whipple's disease. | whipple's disease is a systemic bacterial infection and the common though not invariable manifestations are diarrhoea, weight loss, abdominal pain, and arthralgia. arthritis or arthralgia may be the only presenting symptom, predating other manifestations by years. virtually all organs in the body may be affected, with protean clinical manifestations. various immunological abnormalities, some of which may be epiphenomena, are described. the causative organism is tropheryma whippelii. the disease ... | 2000 | 11085766 |
| endocarditis due to rare and fastidious bacteria. | the etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci. however, the blood culture may contain a bacterium rarely associated with endocarditis, such as lactobacillus spp., klebsiella spp., or nontoxigenic corynebacterium, salmonella, gemella, campylobacter, aeromonas, yersinia, nocardia, pasteurella, listeria, or erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, or ... | 2001 | 11148009 |
| whipple disease and arthritis. | whipple disease is a chronic, multisystem, curable, bacterial infection that usually affects middle-aged men and has a wide range of clinical manifestations. the most common symptoms are weight loss and diarrhea, preceded in three quarters of cases by arthritis for a mean of 6 years. in most patients, periodic acid-schiff staining of proximal small bowel biopsy specimens reveals inclusions within the macrophages, corresponding to bacterial structures. however, patients with various manifestation ... | 2001 | 11148719 |
| whipple's disease and tropheryma whippelii: secrets slowly revealed. | whipple's disease was described in 1907 and was designated "intestinal lipodystrophy," despite the detection of bacteria in 1 specimen. this finding was later substantiated by the success of antibiotic therapy, which resulted in dramatic clinical responses, and by use of electron microscopy, which detected monomorphic bacilli in affected tissues. many attempts at culture failed, and these bacteria were characterized as actinomycetes for the first time by means of broad-range 16s rdna amplificati ... | 2001 | 11170954 |
| tropheryma whippelii dna is rare in the intestinal mucosa of patients without other evidence of whipple disease. | little is known about the pathogenesis of whipple disease, the reservoirs of tropheryma whippelii, and the proportion of persons harboring the bacterium without "classic" intestinal abnormalities. | 2001 | 11177314 |
| culture and immunological detection of tropheryma whippelii from the duodenum of a patient with whipple disease. | culture of tropheryma whippelii has been established only once, in human fibroblast cell lines from a heart valve inoculum. molecular-based diagnostic techniques, although highly sensitive, may be less specific. new diagnostic tools involving isolation of bacteria from contaminated intestinal biopsies and immunohistological detection need to be developed. | 2001 | 11209175 |
| [whipple's disease. histologic diagnosis after the discovery of tropheryma whippelii]. | since the microbiological discovery of tropheryma whippelii, whipple's disease has attracted to new attention in clinical medicine. as small intestinal biopsy is the diagnostic procedure, the impact of knowledge about the histopathological features of whipple's disease and its differential diagnosis has increased. pas-positive macrophages in the intestinal mucosa are the diagnostic hallmark, but further subtyping of cells is important. in whipple's disease macrophages with intensely pas-positive ... | 2001 | 11225449 |
| whipple's disease. report of five cases with different clinical features. | whipple's disease (wd) is a rare systemic disease of infectious etiology which involves the small intestine but can virtually affect any organ. we present here five cases (four males and one female) ranging in age from 20 to 59 years. all patients had intestinal involvement associated or not with clinical manifestations linked to this organ. vegetation in the tricuspid valve was observed in one patient, suggesting endocarditis caused by tropheryma whippelii, with disappearance of the echocardiog ... | 2001 | 11246283 |
| bone marrow involvement in whipple's disease: rarely reported, but really rare? | infection with tropheryma whippelii, the causative agent of whipple's disease, involves nearly every organ. involvement of bone marrow may be an overlooked area of whipple's disease. we report a case of lymphoma-like whipple's disease with bone marrow involvement together with a brief review of the literature on this topic. despite minimal documentation, bone marrow may be commonly involved in whipple's disease and, although not specific, diastase-resistant periodic acid-schiff (pas)-positive ma ... | 2001 | 11260072 |
| rapid ribosequencing--an effective diagnostic tool for detecting microbial infection. | rapid and reliable identification of microorganisms is a prerequisite for the diagnosis and subsequent treatment of infectious diseases. the identification of pathogenic bacteria is traditionally based on their isolation from clinical samples and propagation on culture medium in the routine laboratory. however, despite clinical signs of infection, culture of the pathogenic agent often fails. this may be due to a low number of microorganisms, prior antibiotic treatment, nonculturable microorganis ... | 2001 | 11261751 |
| a case of aortic valve disease associated with tropheryma whippelii infection in the absence of other signs of whipple's disease. | a case of endocarditis caused by tropheryma whippelii is reported. the 69-year-old patient was diagnosed as suffering from severe aortic regurgitation requiring aortic valve replacement, but showed no other symptoms of whipple's disease. t. whippelii was detected in the explanted aortic valve by broad-range pcr amplification of the 16s rdna and subsequent sequence analysis of the product. the etiologic agent was classified as a type 2a sequence variant based on the 16s-23s intergenic spacer and ... | 2001 | 11261759 |
| localization of tropheryma whippelii rrna in tissues from patients with whipple's disease. | whipple's disease is caused by a cultivation-resistant bacterium, tropheryma whippelii. ultrastructural studies of intestinal biopsy specimens from patients with whipple's disease have shown that intracellular and extracellular bacteria are present, but the preferred site of growth is unknown. tissue sections from 8 patients with whipple's disease and from 19 healthy control subjects were analyzed by use of fluorescence in situ hybridization and laser scanning confocal microscopy, to determine t ... | 2001 | 11262205 |
| iron loading: a risk factor for whipple's disease? | because of impairment of microbial iron acquisition ability, some potential pathogens can cause disease only in iron loaded hosts. tropheryma whippelii, the etiologic agent of whipple's disease, is a possible example. whipple's disease is non-contagious, occurs mainly in middle-aged white males, and displays many, but not all, of the complications of hereditary haemochromatosis. tropheryma whippelii is a gastrointestinal commensal that causes disease in persons who have a th1-th2 imbalance. host ... | 2001 | 11421626 |
| rpob sequence analysis of cultured tropheryma whippelii. | until recently no isolate of tropheryma whippelii was available, and therefore genetic studies were limited to those based on pcr amplification of conserved genes. in this study we determined the nucleotide sequence of rpob (encoding the beta-subunit of rna polymerase) from a cultured strain of t. whippelii using degenerate consensus pcr and genome walking. the t. whippelii rpob consists of 3,657 bp with a 50.4% gc content and encodes 1,218 amino acids with a calculated molecular mass of 138 kda ... | 2001 | 11427549 |
| whipple's disease and "tropheryma whippelii". | whipple's disease is a rare bacterial infection that may involve any organ system in the body. it occurs primarily in caucasian males older than 40 years. the gastrointestinal tract is the most frequently involved organ, with manifestations such as abdominal pain, malabsorption syndrome with diarrhea, and weight loss. other signs include low-grade fever, lymphadenopathy, skin hyperpigmentation, endocarditis, pleuritis, seronegative arthritis, uveitis, spondylodiscitis, and neurological manifesta ... | 2001 | 11432814 |
| description of tropheryma whipplei gen. nov., sp. nov., the whipple's disease bacillus. | a detailed characterization was performed of the whipple's disease bacillus, strain twist-marseillet, isolated from the cardiac valve of a patient with whipple's disease bacillus endocarditis. this strain was isolated and maintained on human embryonic lung fibroblast monolayers, but could not be cultivated in the absence of living eukaryotic cells. two morphological forms were observed, with differing staining properties; an intracellular form with intact and degenerating bacteria within vacuole ... | 2001 | 11491348 |
| tropheryma whipplei circulating in blood monocytes. | | 2001 | 11519522 |
| successful treatment of whipple disease diagnosed 36 years after symptom onset. | whipple disease is a rare infectious disorder with multiorgan manifestations and a widely varied clinical presentation. involvement of the small intestine with resultant malabsorption is a classic finding, although extraintestinal manifestations such as fever and arthralgias may precede gastrointestinal symptoms by many years. we describe a 63-year-old man in whom whipple disease was diagnosed 22 years after his initial presentation (36 years after symptom onset) with lymphadenopathy, when a bio ... | 2001 | 11605693 |
| concurrent whipple's disease and giardia lamblia infection in a patient presenting with weight loss. | whipple's disease is an uncommon systemic disease caused by the recently cultured tropheryma whippelii, classically presenting with gastrointestinal symptoms. we report a patient with weight loss and malabsorption in which whipple's disease and concurrent giardia lamblia infection were diagnosed. moreover, multiple small bowel polyps were present. the relationship between concurrent whipple's disease and giardia lamblia infection is discussed. | 2001 | 11711278 |
| antibodies against recombinant heat shock protein 65 of tropheryma whipplei in patients with and without whipple's disease. | tropheryma whipplei is the causative agent of whipple's disease (wd), a chronic, life-threatening infection. laboratory diagnosis is mainly based on pcr and histopathological analysis in duodenal biopsies and other specimens requiring invasive procedures. we have examined the presence of antibodies to recombinant heat shock protein (hsp65) of t. whipplei in patients with whipple's disease as well as in control subjects by western blot and enzyme-linked immunosorbent assay (elisa). a recombinant ... | 2001 | 11714520 |