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Case Reports
. 2022 Sep 15;9(9):e00842.
doi: 10.14309/crj.0000000000000842. eCollection 2022 Sep.

Capsule Endoscopy in the Diagnosis, Disease Mapping, and Monitoring of Treatment Response in Gastrointestinal Whipple's Disease

Emily Davenport  1 , Grigorios Mitsopoulos  1 , Nina Stafford  1 , Arvind Sangwaiya  1 , Sohail Shariq  1
Affiliations
Case Reports

Capsule Endoscopy in the Diagnosis, Disease Mapping, and Monitoring of Treatment Response in Gastrointestinal Whipple's Disease

Emily Davenport et al. ACG Case Rep J. .

Abstract

Whipple's disease is a rare systemic infection causing malabsorption. Affected patients often undergo extensive investigation until final diagnosis with periodic acid-Schiff-positive histology. We present the case of a 73-year-old man diagnosed with Whipple's disease after a prolonged history, with a focus on capsule endoscopy (CE) in both mapping the extent of the pathology and follow-up. We demonstrate pre-treatment and post-treatment CE images, allowing visualization of resolved small bowel pathology, and demonstrate histological resolution. The early use of CE in the investigation of Whipple's disease may expedite diagnosis in patients with more distal bowel pathology and help assess disease severity.

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Figures

Figure 1.
Figure 1.
Gastroscopy image demonstrating prominent lymphangiectasia in the proximal jejunum.
Figure 2.
Figure 2.
Image of the ileum obtained by MiroView capsule endoscopy demonstrating villous atrophy, lymphangiectasia, and clubbed villi with associated luminal narrowing and nodularity.
Figure 3.
Figure 3.
Capsule endoscopy image of the ileum obtained by PillCam shows complete resolution of original pathology after 12 months of antibiotic therapy.
See this image and copyright information in PMC

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