Whipple's disease. Case report.

The paper reports the clinical case of a 58 -year-old male patient admitted for diarrhea (6-7 stools/day, diffuse abdominal pain, borborygma, weight loss (20 kgs in two years), asthenia and fatigue. Physical examination evidenced a poor nutritional state (body mass index 19 kg/m2). The abdomen was slightly distended. Biological tests evidenced moderate/severe anemia, hypoproteinemia and hypoalbuminemia. Endoscopic examination evidenced oedematous duodenal mucosa with white-yellowish deposits. Histology (HE stain) revealed the presence of foamy cells and the PAS-staining of the duodenal mucosa evidenced PAS-positive macrophages and numerous intracellular bacilli. Penicillin therapy 2 x 1 million U/day for 14 days, followed by tetracycline 4 x 250 mg/day improved the clinical picture, the patient had only one stool per day and gained weight. After 7 months of treatment the general condition was good and the patient had gained 17 kgs, the duodenal mucosa was normal. HE staining did not evidence foamy cells and no PAS-positive macrophages could be found.

The prevalence of anti-Helicobacter pylori antibodies in the patients with ischemic heart disease.

The authors proposed to assess the prevalence of anti-Hp antibodies (IgG class) in patients with ischemic heart disease. The study included 93 patients distributed into two groups: a) group A--61 patients with ischemic heart disease; b) group B--32 controls. The Hp infection diagnosis was established by determination of the Hp antibodies in the peripheral blood. Hp infection was correlated with the following factors: (a) smoking, alcohol consumption, antiinflammatory drugs intake and water source; (b) biological parameters (fibrinogen, alpha1-globulins, cholesterol, triglycerides, thrombocyte count). In the patients with ischemic heart disease the prevalence of the Hp infection was 78.3%, and in controls 56.2% (p<0.05). The patients consuming alcohol and smoking had a significantly higher prevalence than controls. Antiinflammatory drugs and water source did not influence the prevalence of the Hp infection. Among the biological parameters, fibrinogen and alpha1 globulins were significantly increased in the Hp-positive patients with ischemic heart disease. In conclusion, the serum prevalence of anti-Hp antibodies was higher in the patients with ischemic heart disease, smokers and alcohol consumers than in health individuals.