Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation
Whipple's disease (WD) is a rare infection caused by the bacterium Tropheryma whipplei that can affect multiple organs and most commonly occurs in the immunocompetent host. Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the f...
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| Veröffentlicht in: | Transplant infectious disease 2016-08, Vol.18 (4), p.617-624 |
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| creator | Vindigni, S.M. Taylor, J. Quilter, L.A.S. Hyun, T.S. Liu, C. Rosinski, S.L. Rakita, R.M. Fredricks, D.N. Damman, C.J. |
| description | Whipple's disease (WD) is a rare infection caused by the bacterium Tropheryma whipplei that can affect multiple organs and most commonly occurs in the immunocompetent host. Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the first case of WD, to our knowledge, in a patient after liver transplantation with comorbid graft‐versus‐host‐disease. We discuss the diagnostic challenges in this setting and the value of electron microscopy and in situ hybridization methods for confirming the infection. WD may be under‐diagnosed in immunosuppressed transplant patients because the disease can present with atypical clinical and histological features that suggest other conditions. |
| doi_str_mv | 10.1111/tid.12562 |
| format | Article |
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Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the first case of WD, to our knowledge, in a patient after liver transplantation with comorbid graft‐versus‐host‐disease. We discuss the diagnostic challenges in this setting and the value of electron microscopy and in situ hybridization methods for confirming the infection. WD may be under‐diagnosed in immunosuppressed transplant patients because the disease can present with atypical clinical and histological features that suggest other conditions.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.12562</identifier><identifier>PMID: 27258480</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Adrenal Cortex Hormones - adverse effects ; Adrenal Cortex Hormones - therapeutic use ; Aged ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - therapeutic use ; Biopsy ; Carcinoma, Hepatocellular - surgery ; Diarrhea - drug therapy ; Diarrhea - microbiology ; Diarrhea - pathology ; Endoscopy, Gastrointestinal ; Fatal Outcome ; gastroenterology ; Graft vs Host Disease - drug therapy ; Graft vs Host Disease - pathology ; graft‐versus‐host disease ; hepatology ; Humans ; immunosuppression ; Immunosuppression - adverse effects ; Immunosuppression - methods ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - therapeutic use ; In Situ Hybridization, Fluorescence ; Intestinal Mucosa - pathology ; liver transplantation ; Liver Transplantation - adverse effects ; Male ; Microscopy, Electron ; Pancytopenia - blood ; Pancytopenia - etiology ; Tropheryma - isolation & purification ; Tropheryma - ultrastructure ; Tropheryma whipplei ; Whipple Disease - blood ; Whipple Disease - drug therapy ; Whipple Disease - microbiology ; Whipple's disease</subject><ispartof>Transplant infectious disease, 2016-08, Vol.18 (4), p.617-624</ispartof><rights>2016 John Wiley & Sons A/S. 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Published by John Wiley & Sons Ltd.</rights><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4232-7cc8e13c0d52015407bca46d483b254b076f5f120b006d7c9782d1b860b9114c3</citedby><cites>FETCH-LOGICAL-c4232-7cc8e13c0d52015407bca46d483b254b076f5f120b006d7c9782d1b860b9114c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.12562$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.12562$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27258480$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vindigni, S.M.</creatorcontrib><creatorcontrib>Taylor, J.</creatorcontrib><creatorcontrib>Quilter, L.A.S.</creatorcontrib><creatorcontrib>Hyun, T.S.</creatorcontrib><creatorcontrib>Liu, C.</creatorcontrib><creatorcontrib>Rosinski, S.L.</creatorcontrib><creatorcontrib>Rakita, R.M.</creatorcontrib><creatorcontrib>Fredricks, D.N.</creatorcontrib><creatorcontrib>Damman, C.J.</creatorcontrib><title>Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Whipple's disease (WD) is a rare infection caused by the bacterium Tropheryma whipplei that can affect multiple organs and most commonly occurs in the immunocompetent host. Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the first case of WD, to our knowledge, in a patient after liver transplantation with comorbid graft‐versus‐host‐disease. We discuss the diagnostic challenges in this setting and the value of electron microscopy and in situ hybridization methods for confirming the infection. WD may be under‐diagnosed in immunosuppressed transplant patients because the disease can present with atypical clinical and histological features that suggest other conditions.</description><subject>Adrenal Cortex Hormones - adverse effects</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biopsy</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Diarrhea - drug therapy</subject><subject>Diarrhea - microbiology</subject><subject>Diarrhea - pathology</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Fatal Outcome</subject><subject>gastroenterology</subject><subject>Graft vs Host Disease - drug therapy</subject><subject>Graft vs Host Disease - pathology</subject><subject>graft‐versus‐host disease</subject><subject>hepatology</subject><subject>Humans</subject><subject>immunosuppression</subject><subject>Immunosuppression - adverse effects</subject><subject>Immunosuppression - methods</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>In Situ Hybridization, Fluorescence</subject><subject>Intestinal Mucosa - pathology</subject><subject>liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Male</subject><subject>Microscopy, Electron</subject><subject>Pancytopenia - blood</subject><subject>Pancytopenia - etiology</subject><subject>Tropheryma - isolation & purification</subject><subject>Tropheryma - ultrastructure</subject><subject>Tropheryma whipplei</subject><subject>Whipple Disease - blood</subject><subject>Whipple Disease - drug therapy</subject><subject>Whipple Disease - microbiology</subject><subject>Whipple's disease</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LAzEQhoMotlYP_gFZ8GB72DbJ7ibZo9SvQsFLRfASstksTdkvk6yl_960Wz0IzmFmmHnmZXgBuEZwinzMnM6nCCcEn4AhitI0jCDBp4eehRjTaAAurN1AiGgap-dggClOWMzgEHysTNOuldlVItiudduWSge6LpR0uqmD8Xs_u7NBrq0SVk38NhBBK5xWtQtE4ZQJSv3lszOitm0paif2x5fgrBClVVfHOgJvT4-r-Uu4fH1ezO-XoYxxhEMqJVMokjBPMERJDGkmRUzymEUZTuIMUlIkBcIwg5DkVKaU4RxljMAsRSiW0QiMe93WNJ-dso5X2kpV-kdU01mOGIKMMBolHr39g26aztT-uz2FEsIYTD016SlpGmuNKnhrdCXMjiPI94Zzbzg_GO7Zm6Nil1Uq_yV_HPbArAe2ulS7_5X4avHQS34DdweIyQ</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>Vindigni, S.M.</creator><creator>Taylor, J.</creator><creator>Quilter, L.A.S.</creator><creator>Hyun, T.S.</creator><creator>Liu, C.</creator><creator>Rosinski, S.L.</creator><creator>Rakita, R.M.</creator><creator>Fredricks, D.N.</creator><creator>Damman, C.J.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201608</creationdate><title>Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation</title><author>Vindigni, S.M. ; Taylor, J. ; Quilter, L.A.S. ; Hyun, T.S. ; Liu, C. ; Rosinski, S.L. ; Rakita, R.M. ; Fredricks, D.N. ; Damman, C.J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4232-7cc8e13c0d52015407bca46d483b254b076f5f120b006d7c9782d1b860b9114c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adrenal Cortex Hormones - adverse effects</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biopsy</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Diarrhea - drug therapy</topic><topic>Diarrhea - microbiology</topic><topic>Diarrhea - pathology</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Fatal Outcome</topic><topic>gastroenterology</topic><topic>Graft vs Host Disease - drug therapy</topic><topic>Graft vs Host Disease - pathology</topic><topic>graft‐versus‐host disease</topic><topic>hepatology</topic><topic>Humans</topic><topic>immunosuppression</topic><topic>Immunosuppression - adverse effects</topic><topic>Immunosuppression - methods</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>In Situ Hybridization, Fluorescence</topic><topic>Intestinal Mucosa - pathology</topic><topic>liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Male</topic><topic>Microscopy, Electron</topic><topic>Pancytopenia - blood</topic><topic>Pancytopenia - etiology</topic><topic>Tropheryma - isolation & purification</topic><topic>Tropheryma - ultrastructure</topic><topic>Tropheryma whipplei</topic><topic>Whipple Disease - blood</topic><topic>Whipple Disease - drug therapy</topic><topic>Whipple Disease - microbiology</topic><topic>Whipple's disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vindigni, S.M.</creatorcontrib><creatorcontrib>Taylor, J.</creatorcontrib><creatorcontrib>Quilter, L.A.S.</creatorcontrib><creatorcontrib>Hyun, T.S.</creatorcontrib><creatorcontrib>Liu, C.</creatorcontrib><creatorcontrib>Rosinski, S.L.</creatorcontrib><creatorcontrib>Rakita, R.M.</creatorcontrib><creatorcontrib>Fredricks, D.N.</creatorcontrib><creatorcontrib>Damman, C.J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vindigni, S.M.</au><au>Taylor, J.</au><au>Quilter, L.A.S.</au><au>Hyun, T.S.</au><au>Liu, C.</au><au>Rosinski, S.L.</au><au>Rakita, R.M.</au><au>Fredricks, D.N.</au><au>Damman, C.J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2016-08</date><risdate>2016</risdate><volume>18</volume><issue>4</issue><spage>617</spage><epage>624</epage><pages>617-624</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Whipple's disease (WD) is a rare infection caused by the bacterium Tropheryma whipplei that can affect multiple organs and most commonly occurs in the immunocompetent host. Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the first case of WD, to our knowledge, in a patient after liver transplantation with comorbid graft‐versus‐host‐disease. We discuss the diagnostic challenges in this setting and the value of electron microscopy and in situ hybridization methods for confirming the infection. WD may be under‐diagnosed in immunosuppressed transplant patients because the disease can present with atypical clinical and histological features that suggest other conditions.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27258480</pmid><doi>10.1111/tid.12562</doi><tpages>8</tpages></addata></record> |
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| subjects | Adrenal Cortex Hormones - adverse effects Adrenal Cortex Hormones - therapeutic use Aged Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Biopsy Carcinoma, Hepatocellular - surgery Diarrhea - drug therapy Diarrhea - microbiology Diarrhea - pathology Endoscopy, Gastrointestinal Fatal Outcome gastroenterology Graft vs Host Disease - drug therapy Graft vs Host Disease - pathology graft‐versus‐host disease hepatology Humans immunosuppression Immunosuppression - adverse effects Immunosuppression - methods Immunosuppressive Agents - adverse effects Immunosuppressive Agents - therapeutic use In Situ Hybridization, Fluorescence Intestinal Mucosa - pathology liver transplantation Liver Transplantation - adverse effects Male Microscopy, Electron Pancytopenia - blood Pancytopenia - etiology Tropheryma - isolation & purification Tropheryma - ultrastructure Tropheryma whipplei Whipple Disease - blood Whipple Disease - drug therapy Whipple Disease - microbiology Whipple's disease |
| title | Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation |
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