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Difference between revisions of "Whipple's disease"
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'''Whipple's disease''' is a rare infectious disease that is classically in the [[duodenum]]. | |||
==General== | |||
Etiology: | |||
*Infection - caused by ''Tropheryma whipplei''<ref name=pmid11777846>{{cite journal |author=Liang Z, La Scola B, Raoult D |title=Monoclonal antibodies to immunodominant epitope of Tropheryma whipplei |journal=Clin. Diagn. Lab. Immunol. |volume=9 |issue=1 |pages=156?9 |year=2002 |month=January |pmid=11777846 |pmc=119894 |doi= |url=http://cvi.asm.org/cgi/pmidlookup?view=long&pmid=11777846}}</ref> a rod-shaped organisms.<ref name=pmid11764080>{{Cite journal | last1 = Alkan | first1 = S. | last2 = Beals | first2 = TF. | last3 = Schnitzer | first3 = B. | title = Primary diagnosis of whipple disease manifesting as lymphadenopathy: use of polymerase chain reaction for detection of Tropheryma whippelii. | journal = Am J Clin Pathol | volume = 116 | issue = 6 | pages = 898-904 | month = Dec | year = 2001 | doi = 10.1309/7678-E2DW-HFJ5-QYUJ | PMID = 11764080 }}</ref> | |||
Epidemiology: | |||
*Very rare. | |||
*Classically middle aged men. | |||
===Clinical=== | |||
*Malabsorption (diarrhea), arthritis + others. | |||
**Symptoms are non-specific. | |||
Treatment: | |||
*Antibiotics - for months and months. | |||
==Microscopic== | |||
Features:<ref name=pmid15476147>{{cite journal | author=Bai J, Mazure R, Vazquez H, Niveloni S, Smecuol E, Pedreira S, Mauriño E | title=Whipple's disease | journal=Clin Gastroenterol Hepatol | volume=2 | issue=10 | pages=849?60 | year=2004 | pmid=15476147 | doi=10.1016/S1542-3565(04)00387-8}}</ref> | |||
*Infectious microorganism typically found in macrophages. | |||
**Macrophages usually abundant - '''key feature''' that should raise Dx in DDx. | |||
**Organisms periodic acid-Schiff (PAS) positive. | |||
DDx: | |||
*[[Mycobacterium avium complex]] (MAC). | |||
===Images=== | |||
<gallery> | |||
Image:Whipple_disease_-_intermed_mag.jpg | Whipple disease - intermed. mag. (WC) | |||
Image:Whipple_disease_-a-_high_mag.jpg | Whipple disease - high mag. (WC) | |||
Image:Whipple2.jpg | Whipple disease - poor quality - low mag. (WC) | |||
</gallery> | |||
==Stains== | |||
*PAS +ve organisms. | |||
*[[AFB stain]] -ve -- to r/o [[MAI]]. | |||
Image: | |||
*[http://www.biomedcentral.com/content/figures/1472-6823-6-3-2-l.jpg Whipple disease - PAS stain (biomedcentral.com)]. | |||
==See also== | |||
*[[Duodenum]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | |||
[[Category:Duodenum]] | |||