Relapsing Whipple's disease presenting with hypopituitarism

Citation
M. Brandle et al., Relapsing Whipple's disease presenting with hypopituitarism, CLIN ENDOCR, 50(3), 1999, pp. 399-403
Citations number
24
Categorie Soggetti
Endocrynology, Metabolism & Nutrition","Endocrinology, Nutrition & Metabolism
Journal title
CLINICAL ENDOCRINOLOGY
ISSN journal
03000664 → ACNP
Volume
50
Issue
3
Year of publication
1999
Pages
399 - 403
Database
ISI
SICI code
0300-0664(199903)50:3<399:RWDPWH>2.0.ZU;2-B
Abstract
A 44-year-old man with a history of Whipple's disease 8 years ago presented with recurrent grand mal seizures and signs of hypopituitarism on physical examination. Magnetic resonance imaging of the brain revealed a hypothalam ic lesion of 1 cm diameter in the region of the rostral infundibulum, Hypop ituitarism was confirmed by low levels of serum cortisol, free testosterone and free thyroxine without an elevated TSH. Whipple encephalitis with hypo thalamic involvement was suggested and verified by positive polymerase chai n reaction (PCR) for Tropheryma whippelii in the cerebrospinal fluid. PCR f or T. whippelii has become an important diagnostic tool for establishing th e diagnosis of Whipple's disease especially in patients with unusual presen tations and if the diagnosis cannot be confirmed histologically, Whipple's disease should be included in the differential diagnosis in hypopituitarism caused by infectious disease.