Title: Gewichtsverlies, pijnlijke gewrichten en vergrote klieren in de buik als uitingen van sarcoïdose, maar ook van de ziekte van Whipple
Other Titles: Weight loss, joint pain and abdominal lymphadenopathy as signs of sarcoidosis, but also of Whipple's disease
Authors: Deeren, D ×
Vanderschueren, Steven
Ectors, Nadine
Blockmans, Daniel Engelbert
Bobbaers, Herman #
Issue Date: 29-Mar-2003
Series Title: Nederlands Tijdschrift voor Geneeskunde vol:147 issue:13 pages:620-624
Abstract: Weight loss, joint pain and abdominal lymphadenopathy as signs of sarcoidosis, but also of Whipple's disease. - Two patients, a woman aged 66 and a man aged 56 years, with an inflammatory syndrome, weight loss, joint pain and abdominal lymphadenopathy received long-term treatment with corticosteroids for alleged sarcoidosis. No long-term remission was induced and the patients were referred for a second opinion. Eventually the diagnosis of Whipple's disease was established 5 years after the appearance of the first symptoms in the case of the female patient and 4 years after in the case of the male patient. Both patients showed a marked clinical improvement after treatment with trimethoprim-sulfamethoxazole. An atypical presentation of alleged sarcoidosis should suggest the possibility of Whipple's disease, especially in the case of gastrointestinal symptoms and the failure to respond to corticosteroids, and warrants duodenal biopsy. The presence of granulomas with an elevated angiotensin-converting enzyme level is not pathognomonic for sarcoidosis. It is vitally important to distinguish the two disorders, as Whipple's disease is an infectious disorder that requires antibiotic therapy to prevent a fatal outcome.
ISSN: 0028-2162
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory for Clinical Infectious and Inflammatory Disorders
Translational Cell & Tissue Research
× corresponding author
# (joint) last author

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