Carroccio A, Soresi M, Montalto G, Bonfissuto G, Amato S, Lo Cascio A, Notarbartolo A
Cattedra di Medicina Interna, Università di Palermo, Italy.
Ital J Gastroenterol. 1996 May;28(4):229-31.
A case is presented of Whipple's disease with mild gastrointestinal symptoms. Abdominal ultrasonography and breath test after lactose load were of great help in the diagnostic phase and follow-up. Ultrasonography showed dilated and thickened ansae and abdominal lymph nodes which were considerably increased in volume and markedly hyperechoic; this latter aspect would seem to be typical of lymph adenomegalia secondary to Whipple's disease and is linked to the accumulation of fats. The breath test showed two H2 peaks, the first being early (30 min after lactose intake) suggesting high seated bacterial colonization. Intestinal biopsy confirmed the diagnosis of Whipple's disease. After 40 days of antibiotic treatment the clinical and laboratory pictures were almost normal and the breath test showed complete disappearance of H2 production, thus confirming the effectiveness of the treatment in eradicating the intestinal bacteria.
本文报告一例有轻微胃肠道症状的惠普尔病病例。腹部超声检查及乳糖负荷后的呼气试验在诊断阶段及随访中作用重大。超声检查显示血管弓扩张、增厚，腹部淋巴结体积显著增大且明显高回声；后一表现似乎是惠普尔病继发淋巴结肿大的典型特征，与脂肪堆积有关。呼气试验显示两个氢气峰，第一个峰出现较早（摄入乳糖后30分钟），提示高位细菌定植。肠道活检确诊为惠普尔病。抗生素治疗40天后，临床及实验室检查结果几乎恢复正常，呼气试验显示氢气产生完全消失，从而证实了治疗对根除肠道细菌的有效性。
