Feurle G E, Utz G, Kies D, Aumüller G
Schweiz Med Wochenschr. 1976 Nov 20;106(47):1642-6.
Three consecutive cases of Whipple's disease observed by us in recent years have involved neurologic symptoms, i.e. psychoorganic syndromes, gaze palsy, nystagmus, masseteric and pharyngeal myoclonus or papilledema. In one case mononuclear cells in the cerebrospinal fluid, most probably of ependymal origin, were loaded with periodic-acid-Schiff (PAS) positive granules. On treatment with antibiotics the neurologic signs cleared considerably or completely. The findings suggest (a) that neurologic involvement Whipple's disease may not be so uncommon as appears from the literature, (b) that examination of the spinal fluid with PAS staining may be helpful in the diagnosis of such cases, and (c) that neurologic involvement in Whipple's disease may also be amenable to treatment with antibiotics.
近年来我们观察到的三例连续性惠普尔病均出现了神经症状,即精神器质性综合征、凝视麻痹、眼球震颤、咬肌和咽肌阵挛或视乳头水肿。在其中一例中,脑脊液中的单核细胞,很可能起源于室管膜,充满了过碘酸希夫(PAS)阳性颗粒。经抗生素治疗后,神经体征有明显改善或完全消失。这些发现表明:(a)惠普尔病的神经受累可能不像文献中显示的那样罕见;(b)脑脊液PAS染色检查可能有助于此类病例的诊断;(c)惠普尔病的神经受累也可能对抗生素治疗有效。