Résumé
Lors d’une infection disséminée à mycobactérie atypique au cours du SIDA, l’atteinte de l’intestin grêle réalise parfois un syndrome anatomo-clinique semblable à celui de la maladie de Whipple. Ses aspects endoscopiques restent mal connus. Nous rapportons une observation particulière par l’aspect endoscopique de la muqueuse duodénale et iléale qui était boursoufflée avec des plis épaissis et parsemée de multiples nodules jaunâtres, surélevés et confluents. Cet aspect, tout à fait comparable à celui décrit dans la maladie de Whipple, correspondait en microscopie optique et électronique à des villosités intestinales distendues, infiltrées massivement par des macrophages bourrés de mycobactéries intactes.
Summary
Mycobaclerial-associated enteritis in AIDS sometimes realized a clinico-pathological syndrome mimicking Whipple’s disease. Its endoscopic features are poorly defined. We report a case made peculiar by the swollen endoscopic aspect of duodenal and ileal mucosa, presenting with thick folds and scattered with multiple, raised, yellowish nodules. This aspect, similar to the one described in Whipple’s disease, corresponded in optical and electronic microscopy to broad intestinal villi loaded foamy macrophages containing intact mycobacteria.
Resumen
En una infección diseminada por micobacteria atípica en un SIDA, la afectación del intestino delgado se manifiesta algunas veces como un sindrome anatomo-clínico parecido al de la enfermedad de Whipple. Su aspecto endoscópico es mal conocido. Presentamos un caso interesante por el aspecto endoscópico de las mucosas duodenal e ileal, que se mostraba engrosada, con pliegues engrosados y sembrada de multiples nódulos amarillentos, sobreelevados y confluentes. Este aspecto, comparable al descrito para la enfermedad de Whipple correspondia, em microcopia óptica y electrónica a vellosidades intestinales engrosadas, infilitradas de forma masiva por macrófagos repletos de micobacterias intactas.
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Pauwels, A., Legendre, C., Mamou, M. et al. Infection disséminée à mycobactérie atypique chez un patient atteint de SIDA. Aspect endoscopique de I’intestin grêle. Acta Endosc 20, 551–555 (1990). https://doi.org/10.1007/BF02966785
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DOI: https://doi.org/10.1007/BF02966785