A 50-year-old man presents with a 3-month history of chronic diarrhea, progressive weight loss, and migratory arthralgias. On examination, he is febrile (38.5°C), tachycardic (102 bpm), with BP 118/76 mmHg and SpO2 98% on room air. He denies recent antibiotic use. Small bowel biopsy demonstrates PAS-positive foamy macrophages in the lamina propria. Laboratory studies show hemoglobin 10.2 g/dL. Which of the following is the most likely diagnosis?
- A)Celiac disease
- B)Whipple diseaseGABARITO
- C)Tropical sprue
- D)Giardiasis
- E)Ulcerative colitis
Explicação
Whipple disease is caused by Tropheryma whipplei and leads to malabsorption with arthralgias, neurologic symptoms, and PAS positive foamy macrophages. Ver explicação completa e trilha adaptativa →