Relapsing Whipple's disease presenting with hypopituitarism

Publication

Relapsing Whipple's disease presenting with hypopituitarism

Journal Paper/Review - Mar 1, 1999

Brändle M, Ammann Peter, Spinas G A, Dutly F, Galeazzi R L, Schmid C, Altwegg M

Units

Kardiologie

PubMed

10435068

Citation

Brändle M, Ammann P, Spinas G, Dutly F, Galeazzi R, Schmid C, Altwegg M. Relapsing Whipple's disease presenting with hypopituitarism. Clinical endocrinology 1999; 50:399-403.

Type

Journal Paper/Review (English)

Journal

Clinical endocrinology 1999; 50

Publication Date

Mar 1, 1999

Issn Print

0300-0664

Pages

399-403

Brief description/objective

A 44-year-old man with a history of Whipple's disease 8 years ago presented with recurrent grand mal seizures and signs of hypopituitarism on physical examination. Magnetic resonance imaging of the brain revealed a hypothalamic lesion of 1 cm diameter in the region of the rostral infundibulum. Hypopituitarism was confirmed by low levels of serum cortisol, free testosterone and free thyroxine without an elevated TSH. Whipple encephalitis with hypothalamic involvement was suggested and verified by positive polymerase chain reaction (PCR) for Tropheryma whippelii in the cerebrospinal fluid. PCR for T. whippelii has become an important diagnostic tool for establishing the diagnosis of Whipple's disease especially in patients with unusual presentations and if the diagnosis cannot be confirmed histologically. Whipple's disease should be included in the differential diagnosis in hypopituitarism caused by infectious disease.