Whipple Pancarditis as a Cause of Heart Failure
Authors: Ram Y. Gordon
Journal: Annals of Internal Medicine (2004)

Letters20 April 2004Whipple Pancarditis as a Cause of Heart FailureRam Y. Gordon, MD, Emily Blumberg, MD, Susan C. Brozena, MD, and Billie Fyfe, MDRam Y. Gordon, MDFrom University of Pennsylvania, and MCP Hahnemann University, Philadelphia, PA.Search for more papers by this author, Emily Blumberg, MDFrom University of Pennsylvania, and MCP Hahnemann University, Philadelphia, PA.Search for more papers by this author, Susan C. Brozena, MDFrom University of Pennsylvania, and MCP Hahnemann University, Philadelphia, PA.Search for more papers by this author, and Billie Fyfe, MDFrom University of Pennsylvania, and MCP Hahnemann University, Philadelphia, PA.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-8-200404200-00036 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Whipple disease is a rare disorder caused by infection with Tropheryma whippelii. We describe a patient who developed classic symptoms and eventual heart failure because of Whipple disease.Case Report: Over a period of 5 years, a 38-year-old man developed frequent loose bowel movements, polyarthralgia, weight loss, edema, and finally dyspnea. On examination, he was thin and appeared ill, with jugular venous distention, a fourth heart sound, and edema. Echocardiography revealed normal left ventricular systolic function, mild right ventricular enlargement, abnormal diastolic septal motion, and a thickened pericardium. Cardiac catheterization revealed normal cardiac output and coronary ...References1. Fleming JL, Wiesner RH, Shorter RG. Whipple's disease: clinical, biochemical, and histopathologic features and assessment of treatment in 29 patients. Mayo Clin Proc. 1988;63:539-51. [PMID: 2453762] CrossrefMedlineGoogle Scholar2. McAllister HA, Fenoglio JJ. Cardiac involvement in Whipple's disease. Circulation. 1975;52:152-6. [PMID: 48435] CrossrefMedlineGoogle Scholar3. Sossai P, DeBoni M, Cielo R. The heart and Whipple's disease [Letter]. Int J Cardiol. 1989;23:275-6. [PMID: 2470691] CrossrefMedlineGoogle Scholar4. Vlietstra RE, Lie JT, Kuhl WE, Danielson GK, Roberts MK. Whipple's disease involving the pericardium: Pathological confirmation during life. Aust N Z J Med. 1978;8:649-51. [PMID: 86351] CrossrefMedlineGoogle Scholar5. Crake T, Sandle GI, Crisp AJ, Record CO. Constrictive pericarditis and intestinal haemorrhage due to Whipple's disease. Postgrad Med J. 1983;59:194-5. [PMID: 6189111] CrossrefMedlineGoogle Scholar6. Kraunz RF. Whipple's disease with cardiac and renal abnormalities. Arch Intern Med. 1969;123:701-6. [PMID: 4181581] CrossrefMedlineGoogle Scholar7. Pelech T, Fric P, Huslarova A, Jirasek A. Interstitial lymphocytic myocarditis in Whipple's disease [Letter]. Lancet. 1991;337:553-4. [PMID: 1705644] CrossrefMedlineGoogle Scholar8. Gubler JG, Kuster M, Dutly F, Bannwart F, Krause M, Vogelin HP, et al . Whipple endocarditis without overt gastrointestinal disease: report of four cases. Ann Intern Med. 1999;131:112-6. [PMID: 10419427] LinkGoogle Scholar9. Billingham ME, Miller DC, Smith JC, et al . Whipple's disease presenting as aortic insufficiency. N Engl J Med. 1981;305:995-8. [PMID: 6168911] CrossrefMedlineGoogle Scholar10. Lie JT, Davis JD. Pancarditis in Whipple's disease: electronmicroscopic demonstration of intracardiac bacillary bodies. Am J Clin Pathol. 1976;66:22-30. [PMID: 59541] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Pennsylvania, and MCP Hahnemann University, Philadelphia, PA.Acknowledgments: The authors thank Marta Torres-Quinones for photographic support and Roberto Nicosia, MD, PhD, and James Diven for support of the ultrastructural analysis. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWhipple Endocarditis without Overt Gastrointestinal Disease: Report of Four Cases Jacques G.H. Gubler , Marcel Kuster , Fabrizio Dutly , Fridolin Bannwart , Martin Krause , Hans Peter Vögelin , Gianni Garzoli , and Martin Altwegg Metrics Cited ByWhipple's diseaseWhipple's disease with muscle impairmentReversible hypothyroidism and Whipple's disease 20 April 2004Volume 140, Issue 8Page: 673-674KeywordsBacillusBiopsyEchocardiographyElectron microscopyHeartHeart diseasesHeart failureInfectious diseasesMyocarditisPericardium ePublished: 20 April 2004 Issue Published: 20 April 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...