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Vol. 10. Issue 6.
Pages 461-465 (January 1999)
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Vol. 10. Issue 6.
Pages 461-465 (January 1999)
Probable enfermedad de Whipple limitada al SNC. Caso clínico
Probable Whipple's disease confined to the CNS. Case report
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A. Aparicio, J.L. Maestro, M. García-Bach, J. Borrás, F. Vila
Servicio de Neurocirugía. Hospital de Mutua de Terrassa. Terrassa (Barcelona)
A. Salas*, C. Sánchez**, G. González*, J. Casalots*
* Servicio de Anatomía Patológica. Hospital de Mutua de Terrassa. Terrassa (Barcelona)
** Servicio de Medicina Interna. Hospital de Mutua de Terrassa. Terrassa (Barcelona)
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Resumen

La enfermedad de Whipple, es una enfermedad sistémica cuyas principales manifestaciones se localizan en el intestino delgado y articulaciones; la afectación primaria del SNC es infrecuente y de difícil diagnóstico cuando no se acompaña de artritis o sintomatología abdominal, más aún, si consideramos a las imágenes TAC y RM como inespecíficas. Presentamos un caso clínico de esta enfermedad, diagnosticado mediante biopsia estereotáxica y tratado a lo largo de 24 meses con Trimetoprim-Sulfametoxazol (TMP-SMX), con importante remisión de la sintomatología y desaparición de la lesión expansiva intracerebral.

Palabras clave:
Enfermedad de Whipple
Trimetoprim-Sulfometoxazol (TMP-SMX)
Biopsia esterotáxica
Macrófagos PAS positivo
Tropheryma whippelii
Summary

The main symptomathology of systemic Wipple's disease is related with the small bowel and joints. Primary CNS involvement is very unusual and it is difficult to diagnose when arthritis ana abdominal symptons are not presento CT and MR images are not considered especific. We present a single case of Whipple's disease diagnosed by stereotactic biopsy and treated with Trimethoprim-Sulfamethoxazole (TMP-SMX) during a twenty-four months period. The patient showed significant remission of symptoms with dissaperance of the expansive cerebrallesion.

Key words:
Whipple Disease
Trimethoprim-Sulfamethoxazole
(TMP-SMX)
Stereotactic biopsy
PAS positive macrophages
Tropheryma whippelii

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