Meier J, Berwanger I, Zangana N, Hellerich O
Staatliches Rheumakrankenhaus, Baden-Baden.
Z Rheumatol. 1994 Nov-Dec;53(6):352-62.
The arthritis of Morbus Whipple is an early clinical manifestation of this rare disease. As the arthritis precedes the gastrointestinal symptoms, very often it is an important early diagnostic clue in this potentially fatal disease. The classical method in establishing the diagnosis is to show the characteristic histologic features in the affected tissues or in small bowel biopsy. Employed in the latter are usually multiple directed biopsies during duodenal endoscopy. This case report gives an example that the duodenum may be spared during active Whipple's disease and even affected tissues must not show the characteristic features of Morbus Whipple.
惠普尔病的关节炎是这种罕见疾病的早期临床表现。由于关节炎先于胃肠道症状出现，它常常是这种潜在致命疾病重要的早期诊断线索。确立诊断的经典方法是在受累组织或小肠活检中显示特征性组织学特征。后者通常采用十二指肠内镜检查时的多处定向活检。本病例报告给出了一个例子，即在活动性惠普尔病期间十二指肠可能未受累，甚至受累组织也不一定显示惠普尔病的特征性表现。
