临床荟萃 ›› 2022, Vol. 37 ›› Issue (12): 1127-1131.doi: 10.3969/j.issn.1004-583X.2022.12.012

• 论著 • 上一篇    下一篇

呼吸系统Whipple病1例并文献复习

李丽芳(), 王鸿雁   

  1. 庆阳市人民医院 呼吸与危重症医学科,甘肃 庆阳 745000
  • 收稿日期:2021-12-29 出版日期:2022-12-20 发布日期:2023-01-18
  • 通讯作者: 李丽芳 E-mail:952027798@qq.com

Respiratory Whipple's disease: A case report and literature review

Li Lifang(), Wang Hongyan   

  1. Department of Respiratory and Critical Care Medicine,Qingyang People's Hospital,Qingyang 745000,China
  • Received:2021-12-29 Online:2022-12-20 Published:2023-01-18
  • Contact: Li Lifang E-mail:952027798@qq.com

摘要:

目的 为进一步提高对罕见病种Whipple病的认识,增强临床医生对疑难病例的诊治能力。方法 报道1例呼吸系统Whipple病的临床特点及诊治过程,并复习文献加以讨论。结果 Whipple病可累及多系统,极少累及肺部,且症状不典型,可表现为发热、干咳、乏力、胸痛、呼吸困难等,胸部CT表现以多发结节和间质性肺病为主,伴有纵隔淋巴结肿大或胸腔积液。通过应用二代基因测序技术(NGS)检测出惠普尔养障体(Tropherymawhippleii,TW)。结论 Whipple病病程隐匿,呼吸系统临床表现不典型,一般实验室及影像学检查均无特异性,确诊有赖于NGS。经给予头孢曲松钠联合多西环素进行治疗,症状缓解,预后良好。

关键词: Whipple病, 肺部感染, 发热

Abstract:

Objective To further improve the understanding of Whipple's disease(WD) as rare diseases, aiming to enhance clinicians' ability for the diagnosis of this intractable cases. Methods The clinical features and treatment process of one case respiratory WD were reported, and the literature was reviewed for discussion. Results WD can involve multiple systems, rarely involve the lungs, and the symptoms are atypical, which can be manifested as fever, dry cough, fatigue, chest pain, dyspnea, etc. Chest CT findings were mainly multiple nodules and interstitial lung disease, accompanied by mediastinal lymphadenopathy or pleural effusion. Tropheryma whippleii (TW) was detected by second-generation gene sequencing (NGS). Conclusion The course of WD is obscure, the clinical manifestation of respiratory system is atypical, and the general laboratory and imaging examinations are non-specific. The diagnosis of WD is helpful to NGS. After treatment with ceftriaxone sodium and doxycycline, the symptoms will be relieved with a good prognosis.

Key words: Whipple's disease, lung infection, fever

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