WHIPPLE’S DISEASE: WHAT IS KNOWN AND WHAT IS NEW

Hela Kchir?, Dhia Kaffel, Faten Limaiem, Dhouha Cherif, Nadia Maamouri and Wafa Hamdi

ABSTRACT

Whipple’s disease is a rare chronic bacterial infection with a multi systemic pattern, due to Tropheryma whipplei. It occurrs in subjects with cell-mediated immunity defects. It generally begins with a recurrent joint lesion in a middle aged man followed by emaciation and diarrhea diversely associated with other clinical manifestations. The main difficulty is to mention the diagnosis in front of an incomplete or atypical clinical presentation. New diagnostic methods based on immunohistochemistry and genetic amplification by polymerase chain reaction allow making the diagnosis in early stages and in atypical forms of the disease. They permit to prescribe early antibiotic therapy, thereby preventing the development of severe late systemic and sometimes fatal forms of the disease.

Keywords: Whipple’s disease; Tropheryma whipplei; Polymerase chain reaction.