- Gram positive rod
- Rare disorder secondary to infection w/T. whipplei
- Possibly sewage, fecal oral spread
- 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
- 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
- Edema, ascites (low albumin from protein losing enteropathy)
- Arthritis (larger joints)
- Darkened skin on sun exposed area (melanoderma)
- Organisms seen on duodenal/small bowel biopsy
- Non-specific lab abnormalities: hypokalemia, iron deficiency anemia (85%), low albumin (90%)