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Whipple Disease: A Two-Decade Multisystem Masquerade Preceding Gastrointestinal Presentation

Year: 2026

Type: article

Abstract: that can present with extraintestinal manifestations preceding gastrointestinal symptoms by years. We report an unusually prolonged course in a patient with nearly 2 decades of treatment-refractory seronegative inflammatory polyarthritis who later developed gastrointestinal symptoms. Although initial upper endoscopy with biopsies was nondiagnostic, repeat evaluation following symptom progression demonstrated small bowel involvement, with diagnosis established by periodic acid-Schiff staining and polymerase chain reaction of small bowel biopsies. This case highlights the diagnostic challenge of Whipple disease and the importance of maintaining clinical suspicion in longstanding refractory symptoms and multisystem involvement.

Source: ACG Case Reports Journal

DOI: 10.14309/crj.0000000000002368

Authors: Sarah Wehbe, Peggy W. Wu, Jiafan Qi, Jeffrey S. Weiser

Institutions: University of Connecticut, UConn Health, UMass Memorial Health Care, UMass Memorial Medical Center, Day Kimball Healthcare

Language: English

Topic: Whipple's Disease and Interleukins

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: American College of Gastroenterology