Difference between revisions of "Whipple's disease"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      = Whipple_disease_-a-_high_mag.jpg
| Image      = Whipple disease - very high mag.jpg
| Width      =
| Width      =
| Caption    = Whipple's disease. [[H&E stain]].
| Caption    = Whipple's disease. [[H&E stain]].
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===Images===
===Images===
<gallery>
<gallery>
Image:Whipple_disease_-_intermed_mag.jpg | Whipple disease - intermed. mag. (WC)
Image: Whipple disease - low mag.jpg | Low mag.
Image:Whipple_disease_-a-_high_mag.jpg | Whipple disease - high mag. (WC)
Image: Whipple disease - intermed mag.jpg | Intermed. mag.
Image: Whipple disease - high mag.jpg | High mag.
Image: Whipple disease - very high mag.jpg | Very high mag.
</gallery>
<gallery>
Image: Whipple disease -a- high mag.jpg | High mag.
Image: Whipple disease -a- very high mag.jpg | Very high mag.
</gallery>
<gallery>
Image:Whipple2.jpg | Whipple disease - poor quality - low mag. (WC)
Image:Whipple2.jpg | Whipple disease - poor quality - low mag. (WC)
</gallery>
</gallery>
==Stains==
==Stains==
*PAS +ve organisms.
*PAS +ve organisms.

Revision as of 03:56, 24 December 2013

Whipple's disease
Diagnosis in short

Whipple's disease. H&E stain.

LM infectious microorganisms - typically in macrophages; macrophages usually abundant
LM DDx mycobacterium avium complex
Stains PAS +ve (microorganisms), AFB -ve
Site duodenum

Clinical history usu. middle aged men
Signs diarrhea
Prevalence very rare
Prognosis good
Treatment antibiotics

Whipple's disease is a rare infectious disease that is classically in the duodenum.

General

Etiology:

  • Infection - caused by Tropheryma whipplei[1] a rod-shaped organisms.[2]

Epidemiology:

  • Very rare.
  • Classically middle aged men.

Clinical

  • Malabsorption (diarrhea), arthritis + others.
    • Symptoms are non-specific.

Treatment:

  • Antibiotics - for months and months.

Microscopic

Features:[3]

  • Infectious microorganism typically found in macrophages.
    • Macrophages usually abundant - key feature that should raise Dx in DDx.
    • Organisms periodic acid-Schiff (PAS) positive.

DDx:

Images


Stains

Image:

See also

References

  1. Liang Z, La Scola B, Raoult D (January 2002). "Monoclonal antibodies to immunodominant epitope of Tropheryma whipplei". Clin. Diagn. Lab. Immunol. 9 (1): 156?9. PMC 119894. PMID 11777846. http://cvi.asm.org/cgi/pmidlookup?view=long&pmid=11777846.
  2. Alkan, S.; Beals, TF.; Schnitzer, B. (Dec 2001). "Primary diagnosis of whipple disease manifesting as lymphadenopathy: use of polymerase chain reaction for detection of Tropheryma whippelii.". Am J Clin Pathol 116 (6): 898-904. doi:10.1309/7678-E2DW-HFJ5-QYUJ. PMID 11764080.
  3. Bai J, Mazure R, Vazquez H, Niveloni S, Smecuol E, Pedreira S, Mauriño E (2004). "Whipple's disease". Clin Gastroenterol Hepatol 2 (10): 849?60. doi:10.1016/S1542-3565(04)00387-8. PMID 15476147.