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Whipple's disease
Saturday, March 22, 2008


A malabsorption disorder. Characteristics - diarrhea, steatorrhea, skin pigmentation, arthralgia, arthritis, lymphadenopathy, and central nervous system lesions. Usual course - progressive; curative with treatment.

CAUSES:
  •probable bacterial infection

DIAGNOSIS:
The diagnosis is suspected when large aggregates of PAS-positive , bacteria-containing macrophages are seen in the small intestine and/or other affected organs. Granulomas may also be seen. The bacteria exhibit an unusual trilaminar cell wall ultrastructure by electron microscopy. Diagnosis is established by polymerase chain reaction amplification of the 16S rRNA gene sequences of these bacteria in tissue. The organism has been isolated in tissue culture. There is evidence indicating  that  Tropheryma whippelii is a ubiquitous environmental or commensal organism causing Whipple's disease in a small subset of individuals. Macrophage dysfunction appears to be a prerequisite for the development of Whipple's disease.

TREATMENT

  • penicillin G´
  • ampicillin´
  • tetracycline´
  • corticosteroids, e.g. ´prednisone´

SYNONYMS:
  •lipophagic intestinal granulomatosis
  •intestinal lipodystrophy
  •secondary nontropical sprue

ICD-9-CM:
040.2 Whipple's disease

posted by Rodolfo T. Rafael,M.D. @ 5:25 PM  
2 Comments:
  • At 2:04 AM, Anonymous Noreen said…

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  • At 11:56 AM, Anonymous Dr: john said…

    This blog always create some informational and amazing things, which add in my knowledge and experience.But I am a bit confuse. Thanks for sharing.Waiting for next post.

     
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Name: Rodolfo T. Rafael,M.D.
Home: San Fabian, Pangasinan, Philippines
About Me: Family Physician, and Associate Professor (Medical Biochemistry, Medical Physiology and Medical Informatics)
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