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Doença de Whipple : abordagem diagnóstica : revisão
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Orientador(es)
Resumo(s)
A Doença de Whipple (DW) é uma patologia rara causada pelo Tropheryma whipplei. Afecta, primordialmente, o sistema gastrointestinal podendo haver um envolvimento multissistémico. Quando se suspeita desta doença deve-se recorrer à combinação de exames complementares de diagnóstico clássicos e alternativos, sendo o exame de primeira linha a realização de EDA, seguida de análise histológica, de pelo menos 5 biópsias duodenais, com coloração de PAS, imunohistoquímica e análise por PCR. Para se confirmar o diagnóstico da doença deve haver dois testes com resultado positivo. Como objectivo deste trabalho pretendo realizar uma revisão sobre a abordagem diagnóstica na Doença de Whipple, de uma forma mais aprofundada, e destacar a importância de novos métodos diagnósticos no contexto desta patologia.
Whipple’s disease is a rare infectious disease caused by Tropheryma whipplei. Whipple’s disease most often affects the gastrointestinal system but also can infect any organ in the body becoming a multisystemic disorder. The process of diagnosing Whipple disease typically includes a combination of classic and alternative tests. The first line test for the diagnosis of Whipple disease is made by a sequence of five biopsies of the duodenum during an upper gastrointestinal endoscopy. Histological analysis reveals PAS-positive, non-acid fast organisms within the macrophages and immunohistochemical staining methods and molecular tests, such as polymerized chain reaction (PCR) can be performed for confirmation of the diagnosis. This diagnosis can only be made if two of the tests confirm positive. The main purpose of this paper is to perform a revision of the several methods used in the diagnosis of Whipple’ disease emphasizing the new diagnosis methods.
Whipple’s disease is a rare infectious disease caused by Tropheryma whipplei. Whipple’s disease most often affects the gastrointestinal system but also can infect any organ in the body becoming a multisystemic disorder. The process of diagnosing Whipple disease typically includes a combination of classic and alternative tests. The first line test for the diagnosis of Whipple disease is made by a sequence of five biopsies of the duodenum during an upper gastrointestinal endoscopy. Histological analysis reveals PAS-positive, non-acid fast organisms within the macrophages and immunohistochemical staining methods and molecular tests, such as polymerized chain reaction (PCR) can be performed for confirmation of the diagnosis. This diagnosis can only be made if two of the tests confirm positive. The main purpose of this paper is to perform a revision of the several methods used in the diagnosis of Whipple’ disease emphasizing the new diagnosis methods.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Doença de Whipple Tropheryma Gastroenterologia