Central Nervous System Involvement as Relapse in Undiagnosed Whipple’s Disease with Atypical Symptoms at Onset
Ioannis Zalonis, Foteini Christidi*, Constantin Potagas, Michalis Rentzos, Ioannis Evdokimidis , Evangelia Kararizou
Department of Neurology, Aeginition Hospital, Medical School, Athens National & Kapodistrian University, 72-74 Vas. Sofias Avenue, Athens, 115 28, Greece
Whipple’s disease (WD) is a rare systemic disease caused by the gram-positive bacillus Tropheryma Whipplei and mostly characterized by arthralgias, chronic diarrhea, weight loss, fever and abdominal pain. Central Nervous System involvement is not uncommon and it may precede other disease manifestations, appear after treatment and improvement of gastrointestinal signs or rarely be the only WD symptom. We report a case in a middle-aged male with unexplained neurological signs and symptoms which were presented as relapse of previously undiagnosed WD with atypical symptoms at onset. After diagnosis confirmation, the patient was appropriately treated which resulted in improvement of major symptoms.
Keywords: Tropheryma whipplei, whipple’s disease, central nervous system, relapse.
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* Address correspondence to this author at the Department of Neurology, Aeginition Hospital, Medical School, Athens National & Kapodistrian University, 72-74 Vas. Sofias Avenue, Athens, 115 28, Greece;
Tel: 0030-210-7289141; Fax: 0030-210-7250410;