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Vol. 30. Issue 7.
Pages 395-398 (August 2007)
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Vol. 30. Issue 7.
Pages 395-398 (August 2007)
Observaciones clínicas
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Hipertrofia amigdalar y adenopatías mesentéricas como manifestaciones predominantes en un paciente con enfermedad de Whipple
Tonsillar hypertrophy and mesenteric adenopathies as the main manifestations in a patient with Whipple's disease
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Ángel Cosme Jiméneza,
Corresponding author
acosme@chdo.osakidetza.net

Correspondencia: Dr. A. Cosme Jiménez. Servicio de Aparato Digestivo. Hospital Donostia. P.° Dr. Beguiristain, s/n. 20014. San Sebastián. Guipúzcoa. España.
, Evelia Ojeda Pérezb, Fernando Neirab, Manuel Vaquero Pérezc, Luis Bujanda Fernández de Piérolaa, Isabel Montalvoa, Nerea Muro Carrala
a Servicio de Aparato Digestivo. Hospital Donostia. San Sebastián. Guipúzcoa. España
b Servicio de Medicina Interna. Hospital Donostia. San Sebastián. Guipúzcoa. España
c Servicio de Anatomía Patológica. Hospital Donostia. San Sebastián. Guipúzcoa. España
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Resumen

La enfermedad de Whipple es una infección crónica poco habitual, cuyo germen causal, Tropheryma whipplei, fue identificado en 1992. En esta entidad es frecuente la participación del intestino, las articulaciones, el sistema nervioso central y el corazón. La presencia de adenopatías abdominales, sobre todo mesentéricas, sin adenopatías periféricas ni síntomas digestivos, articulares, neurológicos o cardíacos, es rara. Se presenta el caso de un paciente con hipertrofia amigdalar, adenopatías mesentéricas, fiebre y síndrome constitucional, en el que se sospechó un linfoma. La biopsia de la amígdala lingual y las adenopatías mesentéricas fueron compatibles con enfermedad de Whipple, diagnóstico que se confirmó mediante reacción en cadena de la polimerasa en sangre.

Whipple's disease is an infrequent chronic infection caused by Tropheryma whipplei, identified in 1992. Intestinal, articular, central nervous system and cardiac involvement is common. The presence of abdominal adenopathies, especially mesenteric adenopathies, without peripheral adenopathies or gastrointestinal, articular, neurological or cardiac symptoms is rare. We present the case of a male patient with tonsillar hypertrophy, mesenteric adenopathies, fever and constitutional syndrome, leading to suspicion of lymphoma. Biopsy findings of the lingual tonsil and mesenteric adenopathies were compatible with Whipple's disease. The diagnosis was confirmed by blood polymerase chain reaction.

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Copyright © 2007. Elsevier España S.L.. Todos los derechos reservados
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