{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:01:44Z","timestamp":1773298904192,"version":"3.50.1"},"reference-count":17,"publisher":"Korean Association for the Study of Intestinal Diseases","issue":"1","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["irjournal.org"],"crossmark-restriction":true},"short-container-title":["Intest Res"],"published-print":{"date-parts":[[2021,1,30]]},"abstract":"<jats:p>Whipple disease is a systemic chronic infection caused by &lt;i&gt;Tropheryma whipplei&lt;\/i&gt;. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acidSchiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from &lt;i&gt;T. whipplei&lt;\/i&gt;. Antibiotic treatment relieved the patient\u2019s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy.<\/jats:p>","DOI":"10.5217\/ir.2019.09177","type":"journal-article","created":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T08:53:12Z","timestamp":1593679992000},"page":"119-125","update-policy":"https:\/\/doi.org\/10.5217\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Whipple disease mimicking inflammatory bowel 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