Zerebraler Morbus Whipple: Welche Diagnostik ist sinnvoll?

Zusammenfassung

Zum diagnostischen Vorgehen beim Verdacht auf eine zerebrale Beteiligung im Rahmen eines Morbus Whipple gehören bildgebende Verfahren und eine Liquoruntersuchung mit einer PCR auf Tropheryma whipplei. Die Symptome einer zerebralen Manifestation sind oft unspezifisch, weshalb die extrazerebralen Symptome und die diesbezügliche Diagnostik wegweisend sein können. Die vorliegende Kasuistik schildert den Krankheitsverlauf zweier Patienten, bei denen weder endoskopisch noch im Liquor ein Erregernachweis gelang und erst durch eine zerebrale Biopsie die Verdachtsdiagnose gestellt und eine spezifische Therapie eingeleitet werden konnte.

Abstract

The diagnostic work-up in the case of a suspected cerebral involvement of Whipple’s disease involves neuroimaging and analysis of cerebrospinal fluid (CSF) including polymerase chain reaction (PCR) assays for Tropheryma whipplei. As neurological findings may be complex and unspecific, extracerebral symptoms often lead to the suspicion of Whipple’s disease. We report the cases of two patients in whom the suspected diagnosis of Whipple’s disease could not be proved either by endoscopy or by the analysis of CSF. Only by means of a cerebral biopsy was the diagnosis assumed and specific therapy was initiated.

Schlüsselwörter

Morbus Whipple - zerebraler Whipple - Tropheryma whipplei

Keywords

Whipple’s disease - cerebral Whipple - Tropheryma whipplei

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