Whipple's disease orbitopathy: case report and review of literature

Orbit. 2022 Feb;41(1):112-117. doi: 10.1080/01676830.2020.1820044. Epub 2020 Sep 10.


A 59-year-old female patient was diagnosed with Whipple's disease (WD) after several months of constitutional complaints and adenopathies that were initially misinterpreted as sarcoidosis. Initial treatment included doxycycline, hydroxychloroquine and prednisolone, which was suspended due to long-term clinical stability. Four months after prednisolone suspension, the patient presented with right periorbital oedema and erythema. Ophthalmological examination revealed restricted eye movements. A computed tomography (CT) scan demonstrated signs of myositis. The patient was treated with anti-inflammatory and antibiotic drugs, that induced remission of the orbitopathy. During the following two years, she presented three relapses, affecting both the right or the left eyes. The last episode was also associated with systemic corticosteroid tapering. Orbitopathy is a rare form of WD presentation and the diagnosis of this condition may be challenging. As the clinical spectrum may range from an incidentaloma to a severe compressive neuropathy, proper recognition and management of WD orbitopathy is essential.

Keywords: Myositis; Whipple’s disease; orbitopathy; tropheryma whipplei.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Doxycycline
  • Female
  • Graves Ophthalmopathy* / drug therapy
  • Humans
  • Middle Aged
  • Tropheryma
  • Whipple Disease* / diagnosis
  • Whipple Disease* / drug therapy


  • Anti-Bacterial Agents
  • Doxycycline