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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Dr. Anna Diels
Klinik und Poliklinik für Neurologie, Uniklinik Köln
Kerpener Str. 62
50924 Köln
eMail: anna.diels@uk-koeln.de
