Inferior Vena Cava Obstruction in Whipple Disease

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Abstract
WHIPPLE disease is an uncommon but treatable disorder that affects the small intestine and virtually any organ system of the body. Malabsorption, fever, arthritis, and generalized lymphadenopathy are frequently characteristic features. The purpose of this communication is to report an unusual presentation of the disease: massive retroperitoneal lymphadenopathy causing inferior vena cava obstruction. Further, the unusual histologic features of noncaseating granulomas within these lymph nodes suggested a sarcoid-like process until the results of a small intestinal biopsy confirmed the diagnosis of Whipple disease. Report of a Case A 60-year-old man entered Providence Hospital with urologic symptoms of frequency, nocturia, and dysuria. After routine examination, a transurethral resection of benign prostatic hypertrophic tissue was performed without event. During recovery, the patient told us of increasing edema of both legs and of foamy, foulsmelling stools occurring frequently over the past six months that had unexpectedly improved during short courses of antibiotic therapy

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