Whipple Disease Presenting as Isolated Transverse Myelitis with Permanent Neurological Damage in a Patient with Systemic Lupus Erythematosus: A Case Report of a Difficult Diagnosis with a Literature Review

Author:

Saffioti Carolina1ORCID,Nebiolo Marta2,Caorsi Roberta3,Mesini Alessio1ORCID,Severino Mariasavina4ORCID,Brisca Giacomo5ORCID,Castagnola Elio1ORCID,Gattorno Marco3ORCID

Affiliation:

1. Pediatric Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy

2. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy

3. Rheumatolgy and Autoinflammatory Diseases Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy

4. Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy

5. Paediatric and Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy

Abstract

We describe an atypical case of Whipple disease exclusively involving the spinal cord in an adolescent receiving immunosuppressive therapy for systemic lupus erythematosus. The diagnosis was particularly difficult since lupus and Whipple disease can present similar clinical features and the patient’s prolonged contact with sewage was initially not mentioned. A literature review of the clinical, imaging, diagnostic, and therapeutic challenges of Whipple disease is also performed.

Funder

Ministero della Salute

Publisher

MDPI AG

Reference84 articles.

1. Tropheryma whipplei infection and Whipple’s disease;Marth;Lancet Infect. Dis.,2016

2. Whipple’s disease;Soliman;J. Neurol. Sci.,2017

3. Central nervous system involvement in whipple disease: Clinical study of 18 patients and long-term follow-up;Compain;Medicine,2013

4. Neurologic disorders in Whipple’s disease;Jovic;Srp. Arh. Za Celok. Lek.,1996

5. Gastroenterology and Neurology;Pfeiffer;Continuum,2017

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