Whipple's Disease as the First Manifestation of Chronic Lymphocytic Leukaemia

Guiomar, Verónica and Pinto, Maria João and Gomes, Clara and Correia, Cristina and Tavares, Sofia and Chaves, Vanessa and Oliveira, Diana (2019) Whipple's Disease as the First Manifestation of Chronic Lymphocytic Leukaemia. European Journal of Case Reports in Internal Medicine, 6 (10). ISSN 2284-2594

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Whipple's disease is a rare multisystemic infectious disease that can mimic lymphoproliferative disorders and must be considered in the differential diagnosis of febrile syndromes. The authors describe the case of a 55-year-old man who presented to the Emergency Department with dyspnoea and abdominal pain. He had a 2-month history of fever, night sweats, asthenia and unintentional weight loss. Upon clinical examination he had bilateral inguinal lymphadenopathy. Blood tests showed iron-deficit anaemia and high C-reactive protein. Abdominal ultrasound showed mesenteric and iliac adenopathies and hepatosplenomegaly. The patient was admitted to the Internal Medicine department for additional testing. Flow cytometry analysis of peripheral blood showed CD5-positive monoclonal B-cell expansion. Excisional biopsy of a retroperitoneal adenopathy guided by computed tomography showed periodic acid–Schiff-positive bacilli inside the macrophages, further identified as Tropheryma whipplei through polymerase chain reaction. Bone marrow biopsy showed a scarce positive CD5 lymphoid population and haematopoietic alterations related to infection. The patient started treatment for T. whipplei with complete symptom resolution. This is the first case describing the simultaneous diagnosis of Whipple's disease and chronic lymphocytic leukaemia in a patient with constitutional symptoms, fever and lymphadenopathies.

Item Type: Article
Uncontrolled Keywords: Fever, lymphadenopathy, Whipple's disease, chronic lymphocytic leukaemia, small lymphocytic lymphoma
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Chiara D'Arpa
Date Deposited: 19 Nov 2020 09:09
Last Modified: 19 Nov 2020 09:09
URI: http://eprints.bice.rm.cnr.it/id/eprint/19524

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