RESUMEN
Whipple's disease is an infrequent multisystemic infection caused by a gram-positive bacterium: Tropheryma whippelii, which after several studies has been characterized as an actinomiceto por 16Sr RNA. It occurs with multiple symptoms, the principal of which are diarrhea, weight loss, stomach pain and arthralgias. Arthritis or artralgia may appear as an isolated symptom and eventually through the years additional digestive, cardiovascular and/or neurological symptoms arise. Diverse immunological abnormalities usually present before or after clinical symptoms are first discovered. Currently there are cabinet, endoscopic, radiological, tomographic and laboratory studies which can help to make a definitive diagnosis, such as the duodenal biopsy submitted to the Schiff test, to the polimerasa chain or an electronic microscopy in order to see the intracellular bacteria in the macrophage and for immunohistochemistry to see specific antibodies to Whipple's disease. Treatment is trimetoprim/sulfametoxazol, it is suggested transfer factor too.
Asunto(s)
Enfermedad de Whipple , Antibacterianos/uso terapéutico , Anticuerpos Antibacterianos/sangre , Artralgia/etiología , Diarrea/etiología , Duodeno/inmunología , Duodeno/microbiología , Humanos , Macrófagos/microbiología , Factor de Transferencia/uso terapéutico , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Tropheryma/genética , Tropheryma/inmunología , Tropheryma/aislamiento & purificación , Pérdida de Peso , Enfermedad de Whipple/diagnóstico , Enfermedad de Whipple/tratamiento farmacológico , Enfermedad de Whipple/inmunología , Enfermedad de Whipple/microbiología , Enfermedad de Whipple/patologíaRESUMEN
The prevalence of class I and class II HLA antigen was analyzed in 14 patients (12 males, two females) with Whipple's disease, diagnosed an average of 9.7 yr (range 6 months to 25 yr) before the typing. They were compared with 174 healthy control subjects of the same geographic area in Argentina. Class I antigens (locus A, B, C) were studied by lymphocytotoxic test, and class II antigens (locus DR, DQ) were detected by the double immunofluorescence technique. HLA-B27 was positive in one patient (7.7%) and in 4% of the control population. No significant association was found with the antigens tested. We observed no difference in the clinical picture or in the frequency of arthralgias, compared with those reported in the literature. Our data suggest that there is no conclusive proof of an association between HLA-B27 and Whipple's disease.