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Case Reports
. 2017 Mar 21;9(3):e1108.
doi: 10.7759/cureus.1108.

Whipple's Disease Manifested as Recurrent Ascites

Ali Aamar  1 , Kamraan Madhani  1 , Muhammad S Anwar  1 , Prabhdeep Singh  1 , Joel Garsten  2
Affiliations
Case Reports

Whipple's Disease Manifested as Recurrent Ascites

Ali Aamar et al. Cureus. .

Abstract

Whipple's disease commonly presents as chronic diarrhea and abdominal pain. Ascites is an uncommon presentation of Whipple's disease. Here, we report a rare case of a 47-year-old male who presented with diarrhea and abdominal distention for three months. The physical examination was significant for ascites. Serum albumin was low and serum-to-ascites albumin gradient was < 1.1 g/dl. This suggested that ascites was less likely to be present due to portal hypertension. Enteroscopy showed erythematous duodenum and jejunum; biopsy was suggestive of periodic acid-Schiff stain (PAS) positive macrophages consistent with Whipple's disease. During the hospital course, the patient improved with intravenous (IV) ceftriaxone.

Keywords: ascites; small intestine; whipple’s disease.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Small Bowel Endoscopy
Small bowel endoscopy showing erythematous and edematous mucosa.
Figure 2
Figure 2. Small Bowel Biopsy
Small bowel biopsy showing PAS positive macrophages in lamina propria.
See this image and copyright information in PMC

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