The Experts below are selected from a list of 30 Experts worldwide ranked by ideXlab platform
Armando Porto - One of the best experts on this subject based on the ideXlab platform.
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poliartrite arrastada e doenca de whipple a proposito de um caso clinico longstanding polyarthritis and Whipples Disease a clinical case
2004Co-Authors: Julia Oliveira, Eliana Araujo, Jorge Cres, Eurico Almiro, Armando PortoAbstract:Whipple’s Disease is a rare systemic Disease caused by a Gram-positive bacillus: Tropheryma whippelii. Diagnosis is based on the clinical picture of arthralgia, weight loss, diarrhea and abdominal pain, symptoms which can often be attributed to other Diseases. Longstanding rheumatic manifestations usually precede the digestive ones, as happened in this case, in which they began seven years prior to diagnosis. A sustained clinical response was present after antibiotic therapy. We conclude with a bibliographic revision of this rare illness.
J Zamecnik - One of the best experts on this subject based on the ideXlab platform.
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peripheral neuropathy in Whipples Disease a case report
Československá patologie, 2012Co-Authors: R Rusina, O Keller, R Sima, J ZamecnikAbstract:Whipples Disease is a chronic multisystem inflammatory Disease with predominantly gastrointestinal manifestations due to Tropheryma whipplei infection. Typical neurological abnormalities include dementia, eye movement abnormalities, hypothalamic dysfunction and oculomasticatory myorhythmias. The literature on peripheral neuropathy in Whipples Disease is sparse and the involvement of peripheral nerves in Whipples Disease has not been documented convincingly so far. We present a case of Whipples Disease presenting by axonal peripheral neuropathy without gastrointestinal involvement. The diagnosis was confirmed by a sural nerve biopsy and consequent PCR of the sample. All clinical signs disappeared progressively during the antibiotic therapy. Two years after the T. whipplei infection, the patient developed dopa-sensitive Parkinson's Disease, although these two events seem to be unrelated. This case illustrates the value of peripheral nerve biopsy in cases of axonal neuropathy of unexplained origin and extends the clinical spectrum of Whipples Disease to a new modality.
A Kyriakidis - One of the best experts on this subject based on the ideXlab platform.
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Whipples Disease a review
Annals of Gastroenterology, 2004Co-Authors: M Pyrgioti, A KyriakidisAbstract:SUMMARY Whipples Disease was described in 1907 and given the name intestinal lipodystrophy until it was found that the agent responsible is a bacterium named Tropheryma whipplei. Its a rare Disease which occurs predominantly in males aged 30-60. The small intestinal mucosa is always affected with lesions that are specific to this Disease. Replacement of most of cellular elements in the lamina propria by macrophages is characteristic of Whipples Disease. It is a systemic Disease that can affect every system, usually causing symptoms in the bowel, the joints, the central nervous and the cardiovascular systems. The diagnosis of Whipples Disease is not easy and depends on a combination of clinical features, the characteristic histopathological findings, the presence of pathognomonic PAS positive macrophages and the PCR of the 16S ribosomal RNA of Tropheryma whipplei. Whipples Disease is lethal if not treated, though it responds dramatically to antibiotic treatment. Patients should be closely monitored during and after treatment because relapses are not uncommon especially when CNS is involved. Key Words: Whipples Disease, Tropheryma whipplei, treatment
Julia Oliveira - One of the best experts on this subject based on the ideXlab platform.
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poliartrite arrastada e doenca de whipple a proposito de um caso clinico longstanding polyarthritis and Whipples Disease a clinical case
2004Co-Authors: Julia Oliveira, Eliana Araujo, Jorge Cres, Eurico Almiro, Armando PortoAbstract:Whipple’s Disease is a rare systemic Disease caused by a Gram-positive bacillus: Tropheryma whippelii. Diagnosis is based on the clinical picture of arthralgia, weight loss, diarrhea and abdominal pain, symptoms which can often be attributed to other Diseases. Longstanding rheumatic manifestations usually precede the digestive ones, as happened in this case, in which they began seven years prior to diagnosis. A sustained clinical response was present after antibiotic therapy. We conclude with a bibliographic revision of this rare illness.
D. Driemeier - One of the best experts on this subject based on the ideXlab platform.
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Colite histiocítica ulcerativa em um cão boxer no Brasil/ Histiocytic ulcerative colitis in a Boxer dog in Brazil
Acta Scientiae Veterinariae, 2011Co-Authors: S. P. Pavarini, Marcele Bettim Bandinelli, E. C. De Oliveira, P. M. Bandarra, C. E. F. Da Cruz, Danilo Carloto Gomes, D. DriemeierAbstract:Background: Histiocytic ulcerative colitis (HUC), also known as granulomatous Boxers colitis or colitis similar to Whipples Disease is a condition affecting especially Boxer dogs. The Disease is characterized by chronic increase in the defecation frequency, tenesmus, fetid dark-brown stools with blood streaks and mucus. Histopathology of a colorectal biopsy confirms the clinical diagnosis, when infiltrates of markedly PAS-positive macrophages are observed in the colonic lamina propria and submucosa. This communication reports a case of histiocytic ulcerative colitis in a Boxer dog in Brazil. Case: A Boxer dog, with one year and three months of age had been presenting, since it was nine months old, increased frequency of defecation, tenesmus, intermittent diarrhea, loose stools with streaks of liquid blood, and coprophagy; however, no weight loss or appetite loss were noticed. After an initial period of three months experiencing the aforementioned signs, the dog started with persistent diarrhea with bright red blood, mild prostration, weight loss, and voracious appetite. Because of continuous deteriorating condition and treatment refractoriness, the dog was euthanized. At necropsy, the colon was decreased in size with thickened mucosa and foci of ulceration, apart of enlarged mesenteric lymph nodes. Tissue fragments were collected and fixed in 10% formalin, processed following standard procedures for histopathology, and stained with Hematoxylin-Eosin (HE). Selected sections from samples of intestines and mesenteric lymph nodes were also stained with Periodic Acid Shiff (PAS) and Brown-Hopps adapted Gram Staining. Microscopic findings in the colon included infiltration with rounded to oval bulky macrophages, with eccentric nuclei and abundant eosinophilic and slightly granular cytoplasm. These macrophages were distributed in the basal lamina propria and submucosa, and there also was diffuse infiltration of lymphocytes and plasma cells. Extensive multifocal mucosal ulcerations with exposure of the submucosa were also observed. The cytoplasm of macrophages was strongly marked when stained by Periodic Acid Schiff. Macrofagos do colon e do linfonodo mesenterico nao coraram pela tecnica de Gram. Discussion: This diagnosis of histiocytic ulcerative colitis was based on the clinical and pathological findings, especially the association of the clinical signs with the infiltrates of markedly PAS-positive macrophages within the colonic lamina propria and submucosa, which is considered a typical characteristic of the condition. The Disease afflicts mainly young Boxer dogs, as it was recorded here. In most cases, there is neither weight loss, nor appetite loss, and the hair coat maintains a healthy appearance. However, in chronic cases such this described here, the dogs may show wasting. Ultrastructural and immunohistochemical findings in macrophages of HUC have indicated the participation of Escherichia coli in the etiopathogeny of the Disease. The Boxer dogs predisposition to HUC has been attributed to a hereditary abnormality that confers invasion and persistence of an adherent E. coli group. This paper reports the importance of the histiocytic ulcerative colitis as an enteric condition affecting Boxer dogs also in Brazil.(AU)
