antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»antibiotics-76Research ArticleВ ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУGUIDELINES FOR PRACTITIONERSБолезнь УипплаWhipple's DiseaseБеловБ. С.BelovB. S.noemail@neicon.ruНИИ ревматологии им. В. А. НасоновойРоссияV. A. Nasonova Research Institute of RheumatologyRussian Federation201806052020633-44449Copyright © ООО «Издательство ОКИ», 20202020ООО «Издательство ОКИ»ООО «Издательство ОКИ»https://www.antibiotics-chemotherapy.ru/jour/about/submissions#copyrightNoticehttps://www.antibiotics-chemotherapy.ru/jour/article/view/76

Болезнь Уиппла (БУ) относится к редким хроническим системным заболеваниям инфекционной этиологии. Возбудитель БУ - Tropheryma whipplei (TW) принадлежит к убиквитарным (повсеместно распространённым) бактериям-комменсалам. Первичное инфицирование протекает асимптомно или в виде одной из острых форм (гастроэнтерит, пневмония и т.д.). При наличии определенного иммунологического дефекта после длительного периода TW-персистенции развиваются локальные хронические формы или происходит генерализация процесса с поражением опорно-двигательного аппарата, желудочно-кишечного тракта, сердечно-сосудистой системы и др. Важная роль в диагностике БУ отводится морфологическому исследованию слизистой оболочки тонкой кишки и ПЦР. Основу лечения составляют 2-4-недельные курсы цефтриаксона или меропенема с последующим длительным (не менее 1 года) приёмом ко-тримоксазола либо доксициклина с гидроксихлорохином. Прогноз БУ в большинстве случаев благоприятный.

Whipple’s disease (WD) is one of rare chronic systemic diseases of infectious etiology. The causative agent of WD -Tropheryma whipplei (TW) - belongs to the ubiquitous bacteria-commensals. Primary infection occurs asymptomatically or in the form of one of the acute forms (gastroenteritis, pneumonia, etc.).If there is a certain immunological defect after a long period of TW-persistence, local chronic forms develop or generalization occurs with the damage to the musculoskeletal system, gastrointestinal tract, cardiovascular system, etc.An important role in the diagnosis of WDis assigned to the morphological study of the small intestine mucosa and PCR. The basis of treatment is 2-4-week course of ceftriaxone or meropenem followed by a long (at least 1 year) intake of co-trimoxazole or doxycycline with hydroxychloroquine.The prognosis of the WD is favorable in most cases.

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The authors declare that there are no conflicts of interest present.