Montes Montes José, Flores Guerrero Roberto, Hernández Mendoza Lilian, Sánchez Olivas Manuel Anastasio, Valencia Zavala Martha Patricia, Martell Pineda Rosa María
Servicio de alergia e inmunología clínica del Hospital General de México, OD.
Rev Alerg Mex. 2009 May-Jun;56(3):92-8.
Whipple's disease is an infrequent multisystemic infection caused by a gram-positive bacterium: Tropheryma whippelii, which after several studies has been characterized as an actinomiceto por 16Sr RNA. It occurs with multiple symptoms, the principal of which are diarrhea, weight loss, stomach pain and arthralgias. Arthritis or artralgia may appear as an isolated symptom and eventually through the years additional digestive, cardiovascular and/or neurological symptoms arise. Diverse immunological abnormalities usually present before or after clinical symptoms are first discovered. Currently there are cabinet, endoscopic, radiological, tomographic and laboratory studies which can help to make a definitive diagnosis, such as the duodenal biopsy submitted to the Schiff test, to the polimerasa chain or an electronic microscopy in order to see the intracellular bacteria in the macrophage and for immunohistochemistry to see specific antibodies to Whipple's disease. Treatment is trimetoprim/sulfametoxazol, it is suggested transfer factor too.
惠普尔病是一种由革兰氏阳性菌——惠普尔嗜组织菌引起的罕见多系统感染，经过多项研究，该菌已被归类为放线菌门16Sr RNA。它会出现多种症状，主要症状包括腹泻、体重减轻、胃痛和关节痛。关节炎或关节痛可能单独出现，多年后最终会出现其他消化、心血管和/或神经症状。各种免疫异常通常在首次发现临床症状之前或之后出现。目前有体格检查、内镜检查、放射学检查、断层扫描和实验室检查有助于做出明确诊断，例如将十二指肠活检组织进行席夫试验、聚合酶链反应或电子显微镜检查，以便观察巨噬细胞内的细菌，并进行免疫组织化学检查以检测针对惠普尔病的特异性抗体。治疗药物是甲氧苄啶/磺胺甲恶唑，也建议使用转移因子。
