Doença de Whipple e endocardite tricúspide: um relato de caso

Abstract

Whipple’s disease (WD) is a rare condition of multiple clinical manifestations and difficult diagnosis. Despite being a disease of insidious evolution, it is frequently neglected and, if not treated, can progress with important sequelae and even death. Diagnosis of WD depends on clinical suspicion, exclusion of alternative conditions and of the use of invasive techniques, which makes its confirmation especially difficult in the localized forms. Although, with correct diagnosis and precocious treatment, it tends to evolve with good control of symptoms and favorable prognosis. We report the case of a male patient of 42 years of age that presented with chronic diarrhea for over 1 year associated with diffuse arthralgia, weight loss and mesenteric adenopathy. The diagnosis of WD was confirmed by digestive endoscopy and duodenal biopsy and complimentary evaluation showed associated tricuspid valve endocarditis. With treatment for WD the patient showed resolution of classic symptomatology as well as regression of the valvular vegetations. This study reports a case of WD with classic manifestation associated with isolated tricúspide valve endocarditis in a patient treated in a reference hospital in Salvador, Bahia, in Brazil. Furthermore, it discusses the challenges associated with the diagnosis and treatment of WD, especially regarding the main cardiovascular manifestation: endocarditis.