Skip to main content
SpringerLink
Log in

Central nervous system involvement in Whipple's disease

  • Case Reports
  • Published:
Neuroradiology Aims and scope Submit manuscript

Summary

A case of Whipple's disease is presented manifesting itself predominantly with neurological and mental symptoms but without gastrointestinal complaints. Although the first cranial CT in the fourth year of the disease was normal, the second, 1.5 years later, revealed intensive hypodensity of the white matter and cortical enhancement. CT findings are compared with autopsy results and a review of the pertinent literature is given.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Badenoch J, Richards WCD, Oppenheimer RD (1963) Encephalopathy in a case of Whipple's disease. J Neurol Neurosurg Psychiatry 26: 203–210

    PubMed  Google Scholar 

  2. Buchholz K, Maintz J, Otto HF (1974) Klinischimmunologische und elektronenmikroskopische Untersuchungen bei Morbus Whipple. Klin Wochenschr 52: 672–677

    Article  PubMed  Google Scholar 

  3. Chears WC, Ashworth CT (1961) Electron microscopic study of the intestinal mucosa in Whipple's disease. Gastroenterology 41: 129–138

    PubMed  Google Scholar 

  4. Claveria LE, duBoulay GH, Moseley JF (1976) Intracranial infections: investigation by computerized axial tomography. Neuroradiology 12: 59–71

    Article  PubMed  Google Scholar 

  5. Cohen AS (1964) An electron microscopic study of the structure of the small intestine in Whipple's disease. J Ultrastruct Res 10: 124–144

    Article  PubMed  Google Scholar 

  6. Davis TD, McBee JW, Borland JL, Kurtz SM, Ruffin JM (1963) The effect of antibiotic and steroid therapy in Whipple's disease. Gastroenterology 44: 112–116

    PubMed  Google Scholar 

  7. Davis JM, Davis KR, Kleinmen GM, Krichner HS, Taveras JM (1978) Computed tomography of herpes simplex encephalitis, with clinicopathological correlation. Radiology 129: 409–416

    PubMed  Google Scholar 

  8. Enzinger FM, Helwig EB (1963) Whipple's disease. Virchows Arch [Pathol Anat] 336: 238–269

    Article  Google Scholar 

  9. Enzman DR, Ranson B, Norman D, Talberth E (1978) Computed tomography of herpes simplex encephalitis. Radiology 129: 419–425

    PubMed  Google Scholar 

  10. Feurle GE, Utz G, Kies D, Aumüller G (1976) Neurologische Manifestationen bei Morbus Whipple. Schweiz Med Wochenschr 106: 1642–1646

    PubMed  Google Scholar 

  11. Font RL, Rao NA, Issarescu S, McEntee WJ (1978) Ocular involvement in Whipple's disease. Arch Ophthalmol 96: 1431–1436

    PubMed  Google Scholar 

  12. Gärtner J (1980) Whipple's disease of the central nervous system associated with ophthalmoplegia externa and severe esteroid hyalitis. Doc Ophthalmol 49: 155–187

    Article  PubMed  Google Scholar 

  13. Gaertner U, Petzold D, Heisig N, Vogel P, Otto HF (1978) Endoskopische Befunde bei Morbus Whipple. Dtsch Med Wochenschr 103: 1740–1742

    PubMed  Google Scholar 

  14. Groodt-Lassell M de, Martin JJ (1969) Etude ultrastructurale des lésions du système nerveux central dans la maladie de Whipple. Pathol Biol (Paris) 17: 121–131

    Google Scholar 

  15. Gyldensted C (1976) Computer tomography of the cerebrum in multiple sclerosis. Neuroradiology 12: 33–42

    Article  PubMed  Google Scholar 

  16. Haubrich WS, Watson JHL, Sieracki JC (1960) Unique morphologic features of Whipple's disease. Gastroenterology 39: 454–468

    PubMed  Google Scholar 

  17. Hecker R, Reid RTW (1962) Cerebral demyelination in Whipple's disease. Med J Aust 1: 211–212

    Google Scholar 

  18. Heinz ER, Drayer BP, Haenggeli CA, Painter MJ, Crumrine P (1979) Computed tomography in white-matter disease. Radiology 130: 371–378

    PubMed  Google Scholar 

  19. Kitamura T (1975) Brain involvement in Whipple's disease. Acta Neuropathol (Berl) 33: 275–278

    Article  Google Scholar 

  20. Knox DL, Bayless TM, Yardley JM, Charache P (1968) Whipple's disease presenting with ocular inflammation and minimal intestinal symptoms. Johns Hopkins Med J 123: 175–179

    PubMed  Google Scholar 

  21. Knox DL, Bayless TM, Pitman FE (1976) Neurologic disease in patients with treated Whipple's disease. Medicine (Baltimore) 55: 467–476

    Google Scholar 

  22. Koudouris SD, Stem TN, Utterback RA (1963) Involvement of central nervous system in Whipple's disease. Neurology (Minneap) 13: 397–404

    Google Scholar 

  23. Krücke W, Stochdorph O (1962) Über Veränderungen im Zentralnervensystem bei Whipple'scher Krankheit. Verh Dtsch Ges Pathol 46: 198–202

    PubMed  Google Scholar 

  24. Kurtz SM, Davis TD, Ruffin JM (1962) Light and electron microscopic studies of Whipple's disease Lab Invest 11: 653–665

    PubMed  Google Scholar 

  25. Lamberty J, Varela PY, Font RG, Jarvis BW, Coover J (1974) Whipple disease. Arch Pathol 96: 325–330

    Google Scholar 

  26. Lampert P, Tom MI, Cumings JN (1962) Encephalopathy in Whipple's disease. Neurology (Minneap) 12: 65–71

    Google Scholar 

  27. Minauf M, Stochdorph O (1969) Das ZNS bei Morbus Whipple. Arch Psychiatr Nervenkr 212: 180–199

    Article  PubMed  Google Scholar 

  28. Mischke LW, Blümcke S, Fritsche D, Küchemann K, Schüler HW, Grözinger KH (1974) Whipple's disease. Etiopathogenesis, treatment, diagnosis and clinical course. Acta Hepatogastroenterol (Stuttg) 21: 307–326

    Google Scholar 

  29. Moppert J, Bianchi L, Bühler H (1968) Zur Morphologie der Dünndarmschleimhaut bei Morbus Whipple (intestinale Lipodystrophie). Virchows Arch [Pathol Anat] 344: 307–321

    Google Scholar 

  30. Otto HF (1977) Morbus Whipple. In: Bartelheimer H, Kühn HA, Becker V, Stelzner F (Hrsg) Gastroenterologie und Stoffwechsel, Bd 9. Thieme, Stuttgart

    Google Scholar 

  31. Pallis CA, Lewis PD (1974) Whipple's disease and the nervous system. In: The neurology of gastrointestinal disease. Saunders, London

    Google Scholar 

  32. Powers JM, Rawe SE (1979) A neuropathologic study of Whipple's disease. Acta Neuropathol (Berl) 48: 223–226

    Article  Google Scholar 

  33. Roberts DM, Themann H, Knust FJ, Preston FE, Donaldson JR (1969) An electron-microscope study of bacteria in two cases of Whipple's disease. J Pathol 100: 249–255

    Article  Google Scholar 

  34. Romanul FCA, Radvany J, Rosales RK (1977) Whipple's disease confined to the brain. J Neurol Neurosurg Psychiatry 40: 901–909

    PubMed  Google Scholar 

  35. Rutishaurer E, Borer F (1960) Aspects morphologiques dans la pathologie de l'intestin gréle. II. La maladie de Whipple. Bibl Gastroenterol (Basel) 2: 80–109

    Google Scholar 

  36. Schliep G, Müller W, Schaefer HE, Schröder R, Passarge C, Seidenfaden J, Stammler A (1979) Morbus Whipple. Fortschr Neurol Psychiatr 47: 167–208

    Google Scholar 

  37. Schochet SS, Lampert PW (1969) Granulomatous encephalitis in Whipple's disease. Acta Neuropathol (Berl) 13: 1–11

    Article  Google Scholar 

  38. Sieracki JC, Fine G (1959) Whipple's disease — observations on systemic involvement. II gross and histologic observations. Arch Pathol 67: 81–93

    Google Scholar 

  39. Sieracki JC, Fine G, Horn RC, Bebin J (1960) Central nervous system involvement in Whipple's disease. J Neuropathol Exp Neurol 19: 70–75

    PubMed  Google Scholar 

  40. Silbert SW, Parker E, Horenstein S (1976) Whipple's disease of the central nervous system. Acta Neuropathol (Berl) 36: 31–38

    Article  Google Scholar 

  41. Smith WT, French JM, Gottsman M, Smith AJ, Wakes-Miller JA (1965) Cerebral complications of Whipple's disease. Brain 88: 137–148

    PubMed  Google Scholar 

  42. Stoupel N, Monseu G, Pardoc A, Heinmann R, Martin JJ (1969) Encephalitis with myoclonus in Whipple's disease. J Neurol Neurosurg Psychiatry 32: 338–343

    PubMed  Google Scholar 

  43. Switz DM, Casey TR, Bogaty GV (1969) Whipple's disease and papilledema. Arch Intern Med 123: 74–77

    Article  PubMed  Google Scholar 

  44. Themann H, Roberts DM, Knust FJ, Schmidt E (1969) Elektronenmikroskopischer Beitrag zum Morbus Whipple. Beitr Pathol Anat 139: 12–36

    PubMed  Google Scholar 

  45. Tracey ML, Brolsma MP (1950) Whipple's disease: report of one case. Gastroenterology 15: 366–369

    PubMed  Google Scholar 

  46. Trier JS, Phelps PC, Eidelmann S, Rubin CE (1965) Whipple's disease: light and electron microscope correlation of jejunal mucosal histology with antibiotic treatment and clinical status. Gastroenterology 48: 684–707

    PubMed  Google Scholar 

  47. Vasquez Rodriguez JJ, Silva Pozo J, Segura A (1972) Whipple'sche Krankheit und Papillödem. Z Gastroenterol 10: 475–479

    PubMed  Google Scholar 

  48. Vogel P, Gaertner U (1979) Cerebrale Manifestation bei Morbus Whipple. Nervenarzt 50: 392–396

    PubMed  Google Scholar 

  49. Whipple GH (1907) A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acids in the intestinal mesenteric lymphatic tissues. Bull Johns Hopkins Hosp 18: 382–391

    Google Scholar 

  50. Wolf M, Wildner GP, Ley J (1970) Elektronenmikroskopische Untersuchungen bei der intestinalen Lipodystrophie (Morbus Whipple). Dtsch Gesundheitswes 25: 677–681

    Google Scholar 

  51. Yardley JH, Hendrix TR (1961) Combined electron and light microscopy in Whipple's disease. Bull Johns Hopkins Hosp 109: 80–98

    PubMed  Google Scholar 

  52. Zimmerman RD, Russell EJ, Leeds NE, Kaufman D (1980) CT in the early diagnosis of herpes simplex encephalitis. AJR 134: 61–66

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuroradiology, University Hospital, Langenbeckstraße 1, D-6500, Mainz, Federal Republic of Germany

    B. Ludwig, J. Bohl & G. Haferkamp

  2. Department of Neuropathology and Neurology, University Hospital, Langenbeckstraße 1, D-6500, Mainz, Federal Republic of Germany

    B. Ludwig, J. Bohl & G. Haferkamp

Authors
  1. B. Ludwig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Bohl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Haferkamp
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ludwig, B., Bohl, J. & Haferkamp, G. Central nervous system involvement in Whipple's disease. Neuroradiology 21, 289–293 (1981). https://doi.org/10.1007/BF02100163

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02100163

Key words

Search

Navigation