Progressive dementia associated with ataxia or obesity in patients with Tropheryma whipplei encephalitis. - Archive ouverte HAL Access content directly
Journal Articles BMC Infectious Diseases Year : 2011

Progressive dementia associated with ataxia or obesity in patients with Tropheryma whipplei encephalitis.

(1) , (2, 3) , (4, 5) , (1) , (3) , (6) , (2) , (1)
1
2
3
4
5
6

Abstract

BACKGROUND: Tropheryma whipplei, the agent of Whipple's disease, causes localised infections in the absence of histological digestive involvement. Our objective is to describe T. whipplei encephalitis. METHODS: We first diagnosed a patient presenting dementia and obesity whose brain biopsy and cerebrospinal fluid specimens contained T. whipplei DNA and who responded dramatically to antibiotic treatment. We subsequently tested cerebrospinal fluid specimens and brain biopsies sent to our laboratory using T. whipplei PCR assays. PAS-staining and T. whipplei immunohistochemistry were also performed on brain biopsies. Analysis was conducted for 824 cerebrospinal fluid specimens and 16 brain biopsies. RESULTS: We diagnosed seven patients with T. whipplei encephalitis who demonstrated no digestive involvement. Detailed clinical histories were available for 5 of them. Regular PCR that targeted a monocopy sequence, PAS-staining and immunohistochemistry were negative; however, several highly sensitive and specific PCR assays targeting a repeated sequence were positive. Cognitive impairments and ataxia were the most common neurologic manifestations. Weight gain was paradoxically observed for 2 patients. The patients' responses to the antibiotic treatment were dramatic and included weight loss in the obese patients. CONCLUSIONS: We describe a new clinical condition in patients with dementia and obesity or ataxia linked to T. whipplei that may be cured with antibiotics.
Fichier principal
Vignette du fichier
1471-2334-11-171.pdf (458.13 Ko) Télécharger le fichier
Vignette du fichier
1471-2334-11-171-S1.DOC (447 Ko) Télécharger le fichier
Vignette du fichier
1471-2334-11-171-S2.DOC (101 Ko) Télécharger le fichier
Vignette du fichier
1471-2334-11-171.xml (93.89 Ko) Télécharger le fichier
Origin : Publisher files allowed on an open archive
Format : Other
Format : Other
Format : Other
Loading...

Dates and versions

inserm-00663940 , version 1 (27-01-2012)

Identifiers

Cite

Florence Fenollar, François Nicoli, Claire Paquet, Hubert Lepidi, Patrick Cozzone, et al.. Progressive dementia associated with ataxia or obesity in patients with Tropheryma whipplei encephalitis.. BMC Infectious Diseases, 2011, 11 (1), pp.171. ⟨10.1186/1471-2334-11-171⟩. ⟨inserm-00663940⟩
167 View
365 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More