The Italian Journal of Neurological Sciences

, Volume 19, Issue 2, pp 101–105

Cerebral Whipple’s disease: clinical and cerebrospinal fluid findings

  • F. Carella
  • P. Valla
  • G. Bernardi
  • G. Parente
  • A. Costa
  • S. Lodrini
Case Report

DOI: 10.1007/BF02427566

Cite this article as:
Carella, F., Valla, P., Bernardi, G. et al. Ital J Neuro Sci (1998) 19: 101. doi:10.1007/BF02427566

Abstract

The case of a patient who had a relapse of cerebral Whipple ’s disease (WD) one year after discontinuation of a two-years’ antibiotic treatment is reported. Neither the clinical course nor the results of magnetic resonance imaging (MRI) and routine examination of the cerebrospinal fluid (CSF) allowed the caring physician to predict the relapse. Retrospective analysis of serial specimens of CSF showed that slight CSF leucocytosis and intrathecal synthesis of IgA might have suggested persistence of infection. The decision to stop antibiotic therapy in cerebral WD is difficult, but evaluation of cell counts and of intrathecal synthesis of IgA may help in the decision. Some patients may need to take treatment indefinitely.

Key words

Whipple’s disease Cerebrospinal fluid Immunoglobulins 

Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • F. Carella
    • 1
  • P. Valla
    • 1
  • G. Bernardi
    • 2
  • G. Parente
    • 3
  • A. Costa
    • 4
  • S. Lodrini
    • 5
  1. 1.Department of NeurologyNational Neurological Institute “C. Besta”MilanoItaly
  2. 2.General LaboratoryNational Neurological Institute “C. Besta”MilanoItaly
  3. 3.Department of GastroenterologyHospital L. SaccoMilanoItaly
  4. 4.Department of NeuroradiologyNational Neurological Institute “C. Besta”MilanoItaly
  5. 5.Department of NeurosurgeryNational Neurological Institute “C. Besta”MilanoItaly