{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:22:04Z","timestamp":1781598124907,"version":"3.54.5"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction Whipple\u2019s disease (WD) is a rare and infectious condition leading to multi-organ impairment caused by Tropheryma whipplei (TW), a ubiquitously occurring bacterium. TW can be detected in tissues by histological detection of PAS (\u201cperiodic acid-ship reaction\u201d)-positive macrophages and by polymerase-chain-reaction (PCR). Clinically, WD is often characterized by diarrhea, abdominal pain, and weight loss. These symptoms are also typical for a flare in Crohn\u2019s disease (CD) and, therefore, can lead to fatal misdiagnosis and wrong treatment by using biologics (e.g., anti-TNF-\u03b1).<\/jats:p>\n                  <jats:p>Case report We here report a young male patient with pre-existing CD. The patient\u2019s symptoms were misinterpreted as a flare of CD and illustrate the multifaceted nature of WD. After intensifying immunosuppressive therapy, the patient developed therapy-refractory diarrhea with several opportunistic infections with a final, fatal outcome.<\/jats:p>\n                  <jats:p>Conclusion Patients with inflammatory bowel disease (IBD) are not only at risk from infectious complications known with clostridium difficile or cytomegalovirus (CMV); infection with WD should also be ruled out by endoscopy and biopsy before the escalation of the immunosuppressive regime.<\/jats:p>","DOI":"10.1055\/a-1747-3666","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T18:54:10Z","timestamp":1645124050000},"page":"598-601","source":"Crossref","is-referenced-by-count":8,"title":["Whipple\u2019s disease \u2013 a rare and challenging complication in a patient with Crohn\u2019s disease"],"prefix":"10.1055","volume":"60","author":[{"given":"Kerem","family":"Bulut","sequence":"additional","affiliation":[{"name":"Clinic for Internal Medicine and Gastroenterology, St. Clemens-Hospital Geldern, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoaneta","family":"Markova","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Clinic of Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali E.","family":"Canbay","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Knappschaftskrankenhaus, Ruhr-University Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang E.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, St. Josef Hospital, Ruhr-University Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2823-6774","authenticated-orcid":false,"given":"Alisan","family":"Kahraman","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Max Grundig Clinic, B\u00fchl\/Baden, B\u00fchl, Germany"},{"name":"Department of Gastroenterology and Hepatology, University Clinic of Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/s1542-3565(04)00387-8","article-title":"Whipple\u2019s disease","volume":"2","author":"JC Bai","year":"2004","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1128\/CMR.00033-16","article-title":"Clinical manifestations, treatment, and diagnosis of Tropheryma whipplei infections","volume":"30","author":"RAV Dolmans","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e71","DOI":"10.1097\/MD.0000000000000714","article-title":"Gastrointestinal diagnosis of classical Whipple disease: clinical, endoscopic, and histopathologic features in 191 patients","volume":"94","author":"U G\u00fcnther","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"52","DOI":"10.3109\/00365529709025063","article-title":"Epidemiology of Whipple\u2019s Disease in Germany: analysis of 110 patients diagnosed in 1965\u201395","volume":"32","author":"A Herbay","year":"1997","journal-title":"Scand J Gastroenterol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1056\/NEJM200003023420903","article-title":"Cultivation of the bacillus of Whipple\u2019s disease","volume":"342","author":"D Raoult","year":"2000","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1038\/nm.1915","article-title":"A replication clock for Mycobacterium tuberculosis","volume":"15","author":"WP Gill","year":"2009","journal-title":"Nat Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.4330\/wjc.v6.i12.1278","article-title":"Complicated Whipple\u2019s disease and endocarditis following tumor necrosis factor inhibitors","volume":"6","author":"T Marth","year":"2014","journal-title":"World J Cardiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/S1473-3099(08)70042-2","article-title":"Whipple\u2019s disease: new aspects of pathogenesis and treatment","volume":"8","author":"T Schneider","year":"2008","journal-title":"Lancet Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/BF00198437","article-title":"Histology of intestinal Whipple\u2019s disease revisited. A study of 48 patients","volume":"429","author":"A Von Herbay","year":"1996","journal-title":"Virchows Arch"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1053\/j.gastro.2009.10.041","article-title":"Efficacy of ceftriaxone or meropenem as initial therapies in Whipple\u2019s disease","volume":"138","author":"GE Feuerle","year":"2010","journal-title":"Gastroenterology"}],"container-title":["Zeitschrift f\u00fcr Gastroenterologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1747-3666.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:37:08Z","timestamp":1764056228000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1747-3666"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,17]]},"references-count":10,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,3,29]]},"published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1747-3666","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0044-2771","1439-7803"],"issn-type":[{"value":"0044-2771","type":"print"},{"value":"1439-7803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,17]]}}}