Whipple's Disease (T Whipplei)

Your Path

  • Whipple's Disease (T Whipplei)

Etiology

  • Gram positive rod
  • Rare disorder secondary to infection w/T. whipplei
  • Possibly sewage, fecal oral spread

Risk Factors

  • Male>female, age 40-60
  • Of those who are infected, only a very small group develop symptoms - ? related to individual immune response and other factors

Symptoms

  • Wt loss
  • Fatigue
  • Rare d/o w/multiple chronic sx
  • Diarrhea (70-80%)
  • Abdominal pain (50%)
  • Intermittent migratory arthralgias (70-80%) that sometimes precedes GI sx for years, involves larger joints→ knees, wrists, ankles
  • F, adenopathy (60%)
  • Broad range neuro sx→ cog impairment, uveitis, ha, supranuclear ophthalmoplegia, other
  • Also skin (40%), cardiac, pulmonary
  • Overall delays in diagnosis due to fact that it's unusual d/o and symptoms vague/multi-system

Physical Exam Findings

  • Weight loss
  • Adenopathy
  • Edema, ascites (low albumin from protein losing enteropathy)
  • Arthritis (larger joints)
  • Darkened skin on sun exposed area (melanoderma)

Tests