Whipple's disease can mimic chronic AIDS enteropathy

• Published in: The American journal of gastroenterology Vol. 86; no. 1; p. 79
• Main Authors: Maliha, G M, Hepps, K S, Maia, D M, Gentry, K R, Fraire, A E, Goodgame, R W
• Format: Journal Article
• Language: English
• Published: United States 01.01.1991
• Subjects: Acquired Immunodeficiency Syndrome - diagnosis; Cryptosporidiosis - complications; Cryptosporidiosis - diagnosis; Diagnosis, Differential; Humans; Male; Middle Aged; Mycobacterium avium-intracellulare Infection - complications; Mycobacterium avium-intracellulare Infection - diagnosis; Opportunistic Infections - complications; Opportunistic Infections - diagnosis; Whipple Disease - complications; Whipple Disease - diagnosis
• ISSN: 0002-9270
• DOI: 10.1111/j.1572-0241.1991.tb06834.x

Previous case reports have demonstrated that the intestinal pathology of Mycobacterium avium-intracellulare (MAI) infection in the acquired immune deficiency syndrome (AIDS) has a light microscopic appearance similar to Whipple's disease. This case report describes a 52-yr-old male patient with a clinical picture suggestive of AIDS, including diarrhea, weight loss, oral thrush, and intestinal cryptosporidiosis. The intestinal biopsy showed light microscopic features compatible with either MAI or Whipple's disease, but electron microscopy confirmed the presence of the Whipple bacillus. Markers of human immunodeficiency virus (HIV) infection were absent. Although immune abnormalities have been reported in Whipple's disease, this is the first report of opportunistic infections complicating this condition. A useful clinical pearl emerges from this and other cases: AIDS can mimic Whipple's disease; Whipple's disease can mimic AIDS.