Love Susannah M, Morrison Lindsay, Appleby Clare, Modi Paul
Liverpool Heart and Chest Hospital, Liverpool, UK.
Interact Cardiovasc Thorac Surg. 2012 Jul;15(1):161-3. doi: 10.1093/icvts/ivs116. Epub 2012 Apr 11.
Whipple's disease, caused by the bacterium Tropheryma whipplei, is a rare chronic multi-system illness commonly affecting the gastrointestinal (GI) tract and presenting with a triad of diarrhoea, weight loss and malabsorption. While 20-55% of patients with a diagnosis of Whipple's disease have clinically evident cardiac manifestations, the initial presentation with isolated valvular disease, without any GI symptoms, is rare. Whereas cardiac involvement usually involves a single valve, cases of double-valve involvement are extremely rare. We report the case of a patient with T. whipplei native aortic and mitral valvular endocarditis, without GI involvement, who presented with the new-onset cardiac failure and ventricular arrhythmias, which required urgent double-valve replacement. This case report is accompanied by a review of the relevant literature.
惠普尔病由鞭毛虫 Tropheryma whipplei 引起，是一种罕见的慢性多系统疾病，通常影响胃肠道（GI），并表现为腹泻、体重减轻和吸收不良三联征。虽然 20%至 55%被诊断为惠普尔病的患者有临床明显的心脏表现，但以孤立性瓣膜病为首发表现且无任何胃肠道症状的情况很少见。虽然心脏受累通常累及单个瓣膜，但双瓣膜受累的病例极为罕见。我们报告了一例患有 T. whipplei 所致原发性主动脉瓣和二尖瓣心内膜炎的患者，该患者无胃肠道受累，表现为新发心力衰竭和室性心律失常，需要紧急进行双瓣膜置换。本病例报告还伴有相关文献综述。
