TY - JOUR T1 - Is the bacterium Tropheryma whipplei cause of the disease in a subgroup of patients with presumed sarcoidosis? JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 1687 AU - Emina Dulic-Lakovic AU - Marianne Hubner AU - Christian Müller AU - Wolfgang Pokieser AU - Melisa Dulic AU - Sabine Publig AU - Meinhard Kneussl AU - Michael Gschwantler Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/1687.abstract N2 - Introduction:Recently we published a case report presenting a patient in whom a causal relationship between pulmonary sarcoidosis and infection with Tropheryma whipplei (T. whipplei) could be demonstrated1. To our best knowledge this is the first systematic study investigating the hypothesis, that in a subgroup of patients presumed sarcoidosis is caused by T. whipplei.Patients and Methods:A total of 56 consecutive patients in whom a diagnosis of sarcoidosis was suspected clinically and confirmed histologically were included in this retrospective study (m:f = 21:35, mean age±SD = 53.6±16.2 (range 24–90 years).PCR-examination for T. whipplei was performed in all patients, using formalin-fixed and paraffin-embedded specimens obtained from organs affected by sarcoidosis [lung (n=22), lymph nodes (n=15), skin (n=7), liver (n=6), other organs (n=6)]. All PCR-examinations were done in an international reference laboratory for Whipple's disease.Results:T. whipplei-RNA was detected in tissues affected by sarcoidosis in 2 of 56 patients (3.6%). Both patients were women (age: 32 and 85 years, respectively) and had enlarged mediastinal and hilar lymph nodes. Histological examination of affected lymph nodes showed granulomatous lymphadenitis of sarcoid type, PAS-staining was negative. Both patients had no gastrointestinal symptoms. Further evaluation for the presence of Whipple's disease is ongoing.Conclusion:Our findings contribute further evidence to the hypothesis, that in a subgroup of patients presumed sarcoidosis is caused by infection with the bacterium T. whipplei. However, this hypothesis should be further evaluated in prospective studies.1 Lancet 2007; 369:1832. ER -