惠普尔病：首例通过电子显微镜和聚合酶链反应诊断的日本病例。
Whipple's disease: the first Japanese case diagnosed by electron microscopy and polymerase chain reaction.
作者信息
Yogi Tatsuji, Hokama Akira, Kinjo Fukunori, Tomiyama Ryosaku, Koide Michio, Kishimoto Kazuto, Makishi Tomoko, Oshiro Masaru, Miyagi Satoru, Kobashigawa Chiharu, Takaki Ryo, Nakayama Takashi, Saito Atsushi
机构信息
First Department of Internal Medicine, University of the Ryukyus, Nishihara, Okinawa.
出版信息
Intern Med. 2004 Jul;43(7):566-70. doi: 10.2169/internalmedicine.43.566.
A 52-year-old man presented with diarrhea and 20 kg weight loss in one year. Enteroscopy showed diffuse yellow-white shaggy mucosa in the duodenum and jejunum. Biopsies of the duodenal mucosa revealed massive infiltration within the lamina propria by foamy macrophages strongly positive for periodic acid-Schiff stain. Electron microscopy demonstrated numerous bacilli within macrophages of the lamina propria. Tropheryma whipplei DNA was detected by polymerase chain reaction. The definitive diagnosis of Whipple's disease was made. Antibiotic therapy dramatically improved his clinical picture. This is the first Japanese case with Whipple's disease diagnosed by electron microscopy and polymerase chain reaction.
一名52岁男性，出现腹泻症状，一年内体重减轻20千克。小肠镜检查显示十二指肠和空肠黏膜弥漫性黄白色粗糙。十二指肠黏膜活检显示固有层内有大量泡沫状巨噬细胞浸润，过碘酸-希夫染色呈强阳性。电子显微镜检查显示固有层巨噬细胞内有大量杆菌。通过聚合酶链反应检测到了惠普尔嗜麦芽糖放线杆菌DNA。确诊为惠普尔病。抗生素治疗使他的临床症状显著改善。这是日本首例通过电子显微镜检查和聚合酶链反应确诊的惠普尔病病例。
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