Review for 10.1186/s12876-021-01664-1 (2021)

Reviewer’s report
Title: 
Whipple's Disease: the great masquerader. A high level of suspicion is the
key to diagnosis
Version: 
0 
Date: 
06 Nov 2020
Reviewer's report:
In the present case series Melas et al described three cases of Whipple disease
(WD), which presented with both gastrointestinal and rheumatologic symptoms
and with a long delay in diagnosis. Main comments:
1) A minor linguistic revision is necessary.
2) Page 5 line 2: what do Authors mean for "thyroid hormone resistance"?
3) My most relevant concern is about case 2. PCR was positive in absence of
PAS-positive macrophages. However, isolate PCR positivity is not diagnostic
since it may identify carriers. What pushed the Authors to conclude for WD?
4) Authors forgot to mention electron microscopy as a diagnostic tool, since it is
able to identify both living bacteria and dead germs after therapy (see Loiodice
A et al, APMIS 2018). Please comment.
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