Benhamou Y, Lachkar S, Cailleux N, Bauer F, Bernet J, Marie I, Lévesque H
Département de médecine interne, CHU de Rouen-Bois-Guillaume, 76031 Rouen cedex, France.
Rev Med Interne. 2009 May;30(5):430-3. doi: 10.1016/j.revmed.2008.12.011. Epub 2009 Mar 9.
Whipple's disease is a systemic infection that may mimic sarcoidosis in its initial presentation. The heart involvement is not uncommon and consists generally in an endocarditis. Myocarditis is less common and is usually accompanied by impairment of heart conduction.
We report a 56-year-old man with Whipple's disease associated with a myocarditis, initially diagnosed as having a sarcoidosis with cardiac injury. The contribution of the histology and molecular biology on intestinal sampling made it possible to rectify the diagnosis.
The diagnosis of Whipple's disease should be considered in the presence of a systemic granulomatosis with or without heart involvement. Early diagnosis is important because of effectiveness of antibiotic therapy.
惠普尔病是一种全身性感染,其初始表现可能类似结节病。心脏受累并不少见,通常表现为心内膜炎。心肌炎较少见,通常伴有心脏传导障碍。
我们报告一名56岁男性,患有与心肌炎相关的惠普尔病,最初被诊断为结节病伴心脏损伤。肠道样本的组织学和分子生物学检查有助于纠正诊断。
在出现伴有或不伴有心脏受累的全身性肉芽肿病时,应考虑惠普尔病的诊断。由于抗生素治疗有效,早期诊断很重要。