An unusual cause of pancytopenia: Whipple's disease
Whipple's disease is a systemic infectious disease caused by the bacteria Tropheryma whipplei. The most common clinical manifestations of Whipple's disease are weight loss (92%), hypoalbuminemia and steatorrhea (91%, respectively), diarrhea (72%), arthralgia (67%), and abdominal pain (55%)...
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| Format: | Article |
| Language: | English |
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Greater Baltimore Medical Center
2014-04-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://www.jchimp.net/index.php/jchimp/article/download/23482/pdf_1 |
| _version_ | 1797968223086313472 |
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| author | Nay T. Tun Shwetanshu Shukla Jaykrishnan Krishnakurup Binu Pappachen Mahesh Krishnamurthy Hayman Salib |
| author_facet | Nay T. Tun Shwetanshu Shukla Jaykrishnan Krishnakurup Binu Pappachen Mahesh Krishnamurthy Hayman Salib |
| author_sort | Nay T. Tun |
| collection | DOAJ |
| description | Whipple's disease is a systemic infectious disease caused by the bacteria Tropheryma whipplei. The most common clinical manifestations of Whipple's disease are weight loss (92%), hypoalbuminemia and steatorrhea (91%, respectively), diarrhea (72%), arthralgia (67%), and abdominal pain (55%). Neurological signs and symptoms from dementia to oculomasticatory myorhythmia or oculofacioskeletal myorhythmia (pathognomonic of Whipple's disease), lymphadenopathy, and fatigue can also be present. Pancytopenia is a rare and less recognized clinical feature in Whipple's disease patients. We are describing a case where a middle-aged Caucasian male diagnosed with Whipple's disease was found to have pancytopenia. Etiology of pancytopenia is postulated to be due to the invasion of bone marrow by T. whipplei. It is important to recognize that bone marrow involvement by the Whipple bacillus is not uncommon. In the presence of lymphadenopathy and pancytopenia, clinicians should think of Whipple's disease as a differential diagnosis apart from lymphoma or other non-specific granulomatous reticuloendothelial disorders. |
| first_indexed | 2024-04-11T02:43:31Z |
| format | Article |
| id | doaj.art-9f9c47e5c1aa43ae8cf8166bbf968b9d |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:43:31Z |
| publishDate | 2014-04-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-9f9c47e5c1aa43ae8cf8166bbf968b9d2023-01-02T18:32:55ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662014-04-01401410.3402/jchimp.v4.2348223482An unusual cause of pancytopenia: Whipple's diseaseNay T. Tun0Shwetanshu Shukla1Jaykrishnan Krishnakurup2Binu Pappachen3Mahesh Krishnamurthy4Hayman Salib5 Department of Internal Medicine, School of Medicine, Easton Hospital, Residency Program, Affiliated with Drexel University, Easton, PA, USA Department of Internal Medicine, School of Medicine, Easton Hospital, Residency Program, Affiliated with Drexel University, Easton, PA, USA Department of Internal Medicine, School of Medicine, Easton Hospital, Residency Program, Affiliated with Drexel University, Easton, PA, USA Department of Internal Medicine, School of Medicine, Easton Hospital, Residency Program, Affiliated with Drexel University, Easton, PA, USA Department of Internal Medicine, School of Medicine, Easton Hospital, Residency Program, Affiliated with Drexel University, Easton, PA, USA Hematology and Oncology Department, School of Medicine, Easton Hospital, Easton, PA, USAWhipple's disease is a systemic infectious disease caused by the bacteria Tropheryma whipplei. The most common clinical manifestations of Whipple's disease are weight loss (92%), hypoalbuminemia and steatorrhea (91%, respectively), diarrhea (72%), arthralgia (67%), and abdominal pain (55%). Neurological signs and symptoms from dementia to oculomasticatory myorhythmia or oculofacioskeletal myorhythmia (pathognomonic of Whipple's disease), lymphadenopathy, and fatigue can also be present. Pancytopenia is a rare and less recognized clinical feature in Whipple's disease patients. We are describing a case where a middle-aged Caucasian male diagnosed with Whipple's disease was found to have pancytopenia. Etiology of pancytopenia is postulated to be due to the invasion of bone marrow by T. whipplei. It is important to recognize that bone marrow involvement by the Whipple bacillus is not uncommon. In the presence of lymphadenopathy and pancytopenia, clinicians should think of Whipple's disease as a differential diagnosis apart from lymphoma or other non-specific granulomatous reticuloendothelial disorders.http://www.jchimp.net/index.php/jchimp/article/download/23482/pdf_1PAS positive macrophagesbone marrow invasionpancytopeniaTropheryma whipplei |
| spellingShingle | Nay T. Tun Shwetanshu Shukla Jaykrishnan Krishnakurup Binu Pappachen Mahesh Krishnamurthy Hayman Salib An unusual cause of pancytopenia: Whipple's disease Journal of Community Hospital Internal Medicine Perspectives PAS positive macrophages bone marrow invasion pancytopenia Tropheryma whipplei |
| title | An unusual cause of pancytopenia: Whipple's disease |
| title_full | An unusual cause of pancytopenia: Whipple's disease |
| title_fullStr | An unusual cause of pancytopenia: Whipple's disease |
| title_full_unstemmed | An unusual cause of pancytopenia: Whipple's disease |
| title_short | An unusual cause of pancytopenia: Whipple's disease |
| title_sort | unusual cause of pancytopenia whipple s disease |
| topic | PAS positive macrophages bone marrow invasion pancytopenia Tropheryma whipplei |
| url | http://www.jchimp.net/index.php/jchimp/article/download/23482/pdf_1 |
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