WHIPPLES-DISEASE - A NONINVASIVE APPROACH FOR SUSPECTED DIAGNOSIS - CASE-REPORT

A case is presented of Whipple's disease with mild gastrointestinal sy mptoms. Abdominal ultrasonography and breath test after lactose load w ere of great help in the diagnostic phase and follow-up. Ultrasonograp hy showed dilated and thickened ansae and abdominal lymph nodes which were considerably increased in volume and markedly hyperechoic; this l atter aspect would seem to be typical of lymph adenomegalia secondary to Whipple's disease and is linked to the accumulation of fats. The br eath test showed two H-2 peaks, the first being early (30 min after la ctose intake) suggesting high seated bacterial colonization. Intestina l biopsy confirmed the diagnosis of Whipple's disease. After 40 days o f antibiotic treatment the clinical and laboratory pictures were almos t normal and the breath test showed complete disappearance of H-2 prod uction, thus confirming the effectiveness of the treatment in eradicat ing the intestinal bacteria.