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Whittle DO, Williams NP, Nicholson AM, et al. Whipple's Disease in an Afro-Caribbean National. West Indian Med J. 2014;63(1):101-4doi: 10.7727/wimj.2012.220.
Whittle, D. O., Williams, N. P., Nicholson, A. M., King-Robinson, K., Kirsch, R., Riddell, R., Mazzulli, T., & Lee, M. G. (2014). Whipple's Disease in an Afro-Caribbean National. The West Indian medical journal, 63(1), 101-4. https://doi.org/10.7727/wimj.2012.220
Whittle, D O, et al. "Whipple's Disease in an Afro-Caribbean National." The West Indian medical journal vol. 63,1 (2014): 101-4. doi: https://doi.org/10.7727/wimj.2012.220
Whittle DO, Williams NP, Nicholson AM, King-Robinson K, Kirsch R, Riddell R, Mazzulli T, Lee MG. Whipple's Disease in an Afro-Caribbean National. West Indian Med J. 2014 Jan;63(1):101-4. doi: 10.7727/wimj.2012.220. Epub 2014 Jan 06. PMID: 25303201; PMCID: PMC4655628.
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West Indian Med J. 2014 Jan;63(1):101-4. doi: 10.7727/wimj.2012.220. Epub 2014 Jan 06.

Whipple's Disease in an Afro-Caribbean National.

The West Indian medical journal

D O Whittle, N P Williams, A M Nicholson, K King-Robinson, R Kirsch, R Riddell, T Mazzulli, M G Lee

Affiliations

  1. Department of Medicine, The University of the West Indies, Kingston 7, Jamaica.
  2. Department of Pathology, The University of the West Indies, Kingston 7, Jamaica.
  3. Department of Microbiology, The University of the West Indies, Kingston 7, Jamaica.
  4. Department of Pathology and Laboratory Medicine and Microbiology, Mount Sinai Hospital, Toronto, Canada.
  5. University of Toronto, Toronto, Canada.
  6. Department of Medicine, The University of the West Indies, Kingston 7, Jamaica. [email protected].

PMID: 25303201 PMCID: PMC4655628 DOI: 10.7727/wimj.2012.220

Abstract

Whipple's disease is a rare multi-organ infectious disease caused by Tropheryma whipplei. It is fatal without treatment. We report on a 40-year old Afro-Jamaican man who presented with a six-month history of weight loss and diarrhoea. Investigations revealed iron deficiency anaemia and hypoalbuminaemia. Upper gastrointestinal endoscopy revealed white patchy lesions in the duodenum. The duodenal biopsy showed broadening and thickening of the villi by a dense infiltrate of foamy histiocytes within the lamina propria and focally extending into the attached submucosa. Periodic Acid-Schiff stains were positive. Electron microscopy was confirmatory and polymerase chain reaction testing conclusively identified the organisms as T whipplei. Antibiotic treatment resulted in resolution of symptoms. Although the diagnosis of Whipple's disease is difficult, increased awareness should lead to an increase in reported cases with the improvements in diagnostic capabilities.

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