Whipple Disease

Question 1

Rare cause of diarrhea with weight loss, malabsorption, skin hyperpigmentation, migratory arthritis
seen in men around age 50 yrs old

Answer 1

Whipple dx

Question 2

how to diagnose Whipple’s disease

Answer 2

need EGD and multiple gastric and small bowel biopsies for diagnosis

Question 3

what is seen on histological findings for whipple dx

Answer 3

PAS positive macrophages and foamy macrophages and lamina propria and villous atrophy

Question 4

Tropheryma whipplei is a

Answer 4

gram positive non acid fast PAS positive ROD.

Question 5

treatment of whipple’s dx

Answer 5

ceftriaxone IV for 2 weeks

OR

IV penicillin for 2 weeks

both are regimens

followed by bactrim for 12 months

Question 6

what is a sequelae of whipple’s dx

Answer 6

also see neurological symptoms

can get CSF sample via LP as this changes duration of treatment

Question 7

does whipple dx pts have relapse?

Answer 7

yes up to 20% have relapse

need re treatment with longer duration of antibiotics.