Whipple Disease: A Two-Decade Multisystem Masquerade Preceding Gastrointestinal Presentation.
4 affiliations
- 1Department of Medicine, University of Connecticut, Farmington, CT.
- 2Division of Rheumatology, UMass Memorial Health, Worcester, MA.
- 3Department of Pathology, Day Kimball Health, Putnam, CT.
- 4Connecticut GI, Farmington, CT.
Abstract
Whipple disease is a rare multisystem infection caused by Tropheryma whipplei that can present with extraintestinal manifestations preceding gastrointestinal symptoms by years. We report an unusually prolonged course in a patient with nearly 2 decades of treatment-refractory seronegative inflammatory polyarthritis who later developed gastrointestinal symptoms. Although initial upper endoscopy with biopsies was nondiagnostic, repeat evaluation following symptom progression demonstrated small bowel involvement, with diagnosis established by periodic acid-Schiff staining and polymerase chain reaction of small bowel biopsies. This case highlights the diagnostic challenge of Whipple disease and the importance of maintaining clinical suspicion in longstanding refractory symptoms and multisystem involvement.
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BibTeX
@article{wehbe2026whipple,
title = {{Whipple Disease: A Two-Decade Multisystem Masquerade Preceding Gastrointestinal Presentation.}},
author = {Sarah Wehbe and Peggy W Wu and Jiafan Qi and Jeffrey S Weiser},
journal = {ACG case reports journal},
year = {2026},
month = oct,
doi = {10.14309/crj.0000000000002368},
url = {https://europepmc.org/article/MED/42910090},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Whipple Disease: A Two-Decade Multisystem Masquerade Preceding Gastrointestinal Presentation.
AU - Sarah Wehbe
AU - Peggy W Wu
AU - Jiafan Qi
AU - Jeffrey S Weiser
PY - 2026
DA - 2026/10/21
JO - ACG case reports journal
DO - 10.14309/crj.0000000000002368
UR - https://europepmc.org/article/MED/42910090
AB - Whipple disease is a rare multisystem infection caused by Tropheryma whipplei that can present with extraintestinal manifestations preceding gastrointestinal symptoms by years. We report an unusually prolonged course in a patient with nearly 2 decades of treatment-refractory seronegative inflammatory polyarthritis who later developed gastrointestinal symptoms. Although initial upper endoscopy with biopsies was nondiagnostic, repeat evaluation following symptom progression demonstrated small bowel involvement, with diagnosis established by periodic acid-Schiff staining and polymerase chain reaction of small bowel biopsies. This case highlights the diagnostic challenge of Whipple disease and the importance of maintaining clinical suspicion in longstanding refractory symptoms and multisystem involvement.
SN - 2326-3253
ER -