Gemeinsames Auftreten von Morbus Whipple und Hyperparathyreoidismus – Zufall oder kausaler Zusammenhang?

Zusammenfassung

Der Morbus Whipple ist eine seltene Infektionserkrankung mit multiplen klinischen Manifestationen. Die nach dem Erstbeschreiber George Hoyt Whipple benannte Erkrankung wurde 1907 im Rahmen der Autopsie eines 36-Jährigen mit Gewichtsverlust, Diarrhoen und Arthritis entdeckt. Unter dem Mikroskop entdeckte Whipple ein stäbchenförmiges Bakterium in der Darmwand des Patienten, welches erst 1992 als neue Bakterienspezies bestätigt und als Tropheryma whipplei benannt wurde.

Ein Rezidiv des Morbus Whipple kann auch Jahre nach der initialen Diagnose auftreten und manifestiert sich häufig mit extraintestinalen Symptomen wie Arthritiden oder Hauteffloreszenzen, Jahre vor einem gastrointestinalen Beschwerdebild. Das im vorliegenden Fall festgestellte, simultane Auftreten mit einem primären Hyperparathyreoidismus ist jedoch ein bislang unbekanntes Krankheitsbild und eröffnet neue Fragen und Perspektiven im Rahmen der Diagnostik und Therapie.

Abstract

Whipple’s disease is a rare infectious disease with multiple clinical manifestations. The disease is named after George Hoyt Whipple, who first recorded the illness in 1907 after conducting the autopsy of a 36-year-old man with weight loss, diarrhea, and arthritis. Under the microscope, Whipple discovered a rod-shaped bacterium in the patient's intestinal wall, which was not confirmed as a new bacterial species until 1992, when it was named Tropheryma whipplei.

Recurrence of Whipple’s disease can occur years after an initial diagnosis and often manifests with extraintestinal symptoms such as arthritides or skin efflorescences, years before a gastrointestinal complaint. However, the simultaneous occurrence of primary hyperparathyroidism in the present case is a hitherto unknown clinical picture and opens up new questions and perspectives in the context of diagnostics and therapy.

Schlüsselwörter

Darm - Morbus Whipple - Hyperparathyreoidismus - Rezidiv - Polymerasekettenreaktion - Nebenschilddrüsenadenom

Keywords

colon - Whipple’s disease - hyperparathyroidism - recurrence - Polymerase chain reaction - parathyroid adenoma

Publication History

Received: 23 July 2022

Article published online:
10 January 2023

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