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Background: Pulmonary hypertension is an uncommon feature of Whipple's disease and the underlying pathophysiological mechanism remains a subject of debate., Case Report: A 57-year-old woman was hospitalized for exploration of migrating joint pain that had developed for 5 years. Histologically proven Whipple's disease was diagnosed on duodenal biopsies. The lung angiogram performed to explore signs of right heart failure demonstrated pulmonary hypertension and ruled out pulmonary embolism. Abundant pericardial effusion developed progressively. Antibiotic therapy using sulfamethoxazole-trimethoprime led to a systemic Jarisch Herxheilmer reaction. The pulmonary hypertension resolved rapidly, the pericardial effusion more slowly., Discussion: The pulmonary hypertension in this patient appeared to be directly related to Whipple's disease, probably via vascular infiltration by Tropheryma whippeli.

Background: Vitamin B1 deficiency (beriberi) is very uncommon in France. It leads to high output cardiac failure totally different from the situation observed in alcoholic patients. We report a typical case of cardiac beriberi., Case Report: The patient was referred for dyspnea with high output cardiac failure. Echocardiography evidenced severe pulmonary hypertension and high cardiac output. The more common causes of heart failure were ruled out. The dietary habits of the patient (suggested beriberi which was confirmed by the low serum thiamin and therapeutic test with vitamin B1., Discussion: High output cardiac failure should suggest possible Shoshin beriberi, particularly in subjects with imported dietary habits living in a precarious socioeconomic situation.