Cerebral Whipple's disease. Diagnosis by brain biopsy

Am J Clin Pathol. 1980 Oct;74(4):486-90. doi: 10.1093/ajcp/74.4.486.

Abstract

Whipple's disease, a multisystem chronic granulomatous disease treatable by antibiotics, usually presents clinically with gastrointestinal or joint symptoms. Usually, the diagnosis is substantiated by small intestinal biopsy. This shows diastase-resistant periodic-acid-Schiff-(PAS)-positive inclusions in the cytoplasm of macrophages within the lamina propria. By electron microscopy, this PAS-positive material consists of 1.5 X 0.2-mum bacilli and fine fibrillar material within macrophage phagolysosomes. Rarely, Whipple's disease presents clinically as a primary neurologic disease without gastrointestinal symptoms. Because untreated cerebral Whipple's disease usually progresses rapidly to death, it is imperative to establish the diagnosis promptly. This report describes a case of cerebral Whipple's disease without gastrointestinal symptoms that was diagnosed early by light-and electron-microscopic study of brain biopsy material.

Publication types

  • Case Reports

MeSH terms

  • Biopsy*
  • Brain / ultrastructure*
  • Brain Diseases / diagnosis*
  • Brain Diseases / pathology
  • Humans
  • Male
  • Middle Aged
  • Whipple Disease / diagnosis*
  • Whipple Disease / pathology