Whipple Disease

Question 1

Whipple’s disease is a rare multi-system disorder caused by

Answer 1

Tropheryma whippelii infection

Question 2

Risk factors for whipple disease

Answer 2

HLAB27
Middle Ages men

Question 3

Features of whipple disease

Answer 3

malabsorption: diarrhoea- pale floating stools , weight loss

large-joint arthralgia

lymphadenopathy

skin: hyperpigmentation and photosensitive rash

pleurisy,

pericarditis

neurological symptoms (rare): ophthalmoplegia, dementia, seizures, ataxia, myoclonus

Question 4

Diagnosis ?

Answer 4

jejunal biopsy shows deposition of macrophages containing Periodic acid-Schiff (PAS) granules

Question 5

Tx of Tropheryma whippelii infection

Answer 5

oral co-trimoxazole for a year - lowest relapse rate,
sometimes preceded by a course of IV penicillin