{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:40:28Z","timestamp":1784990428771,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Whipple's disease is a systemic chronic bacterial infection caused by <jats:italic>Tropheryma whipplei<\/jats:italic>, a gram\u2010positive bacillus. <jats:italic>T. whipplei<\/jats:italic> infection in the small intestine often causes malabsorption and is often accompanied by gastrointestinal symptoms such as diarrhea and abdominal pain. In this report, we describe our experience with a case of Whipple's disease in which the affected patient did not have the typical gastrointestinal symptoms. The patient was an 80\u2010year\u2010old male who presented with complaints of weight loss and lower leg edema due to malabsorption and shortness of breath during exertion. A blood test revealed a decreased albumin level and an elevated C\u2010reactive protein level. Endoscopic images revealed diffuse white villi, the presence of which extended from the duodenum to the upper jejunum. We made a diagnosis of Whipple's disease based on pathological findings associated with the duodenum, electron microscopic findings, and findings of polymerase chain reaction (PCR) tests (performed using mucosal tissue). Clinical symptoms and endoscopic findings improved with antibiotics. Real\u2010time PCR tests were performed for a quantitative evaluation of the effect of treatment. Endoscopy is useful for diagnosing Whipple's disease when there is an absence of gastrointestinal symptoms, and hypoalbuminemia of unknown etiology is observed.<\/jats:p>","DOI":"10.1002\/deo2.37","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T05:49:32Z","timestamp":1630561772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Endoscopic diagnosis of Whipple disease in a patient without gastrointestinal symptoms: A case report"],"prefix":"10.1002","volume":"2","author":[{"given":"Yujiro","family":"Henmi","sequence":"first","affiliation":[{"name":"Moriguchi Keijinkai Hospital  Osaka Japan"},{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-4690","authenticated-orcid":false,"given":"Yuki","family":"Hirata","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiko","family":"Koubayashi","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Hara","sequence":"additional","affiliation":[{"name":"Katsuragi Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Naka","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Kakimoto","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaharu","family":"Nouda","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"},{"name":"Midorigaoka Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Moriguchi Keijinkai Hospital  Osaka Japan"},{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihisa","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhide","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"382","article-title":"A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues","volume":"18","author":"Whipple GH","year":"1907","journal-title":"Johns Hopkins Med J"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200101000-00012"},{"key":"e_1_2_7_4_1","first-page":"79","article-title":"Whipple's disease and ankylosing spondylitis simultaneous occurrence in HLA\u2010B27 positive male","volume":"5","author":"Canoso JJ","year":"1978","journal-title":"J Rheumatol"},{"key":"e_1_2_7_5_1","first-page":"80","article-title":"Combined electron and light microscopy in Whipple's disease. Demonstration of \u201cbacillary bodies\u201d in the intestine","volume":"109","author":"Yardley JH","year":"1961","journal-title":"Bull Johns Hopkins Hosp"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200003023420903"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra062477"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70042-2"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.3.1119-1120.2002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.9631-17"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70042-2"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.37","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.37","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.37","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T13:16:37Z","timestamp":1692882997000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.37"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/deo2.37"],"URL":"https:\/\/doi.org\/10.1002\/deo2.37","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9]]},"assertion":[{"value":"2021-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e37"}}