Whipple's Disease Flashcards
1
Q
What is Whipple’s disease?
A
Rare infectious bacterial disease which is caused by Tropheryma Whipplei
2
Q
Who gets it?
A
White middle aged males
3
Q
How does it present?
A
-Arthritis
-Arthralgia
-Diarrhoea
-Abdominal pain
-Weight loss
-Peripheral lymphadenopathy
-Blood test- chronic malabsorption
Endoscopy- pale, shaggy duodenal mucosa with eroded, red, friable patches
4
Q
How is Whipples diagnosed?
A
- Small bowel biopsy
- Periodic acid-Schiff (+ve macrophages are present)
- Electron microscopy
- Antibodies can be identified by immunochemistry
- PCR assay is confirmatory polymerase
5
Q
What does electron microscopy show in Whipple’s disease?
A
Characteristic trilaminar cell wall of T Whipplei can be seen in the macrophages
6
Q
How is Whipple’s disease treated?
A
- ABs which cross blood brain barrier
- 160mg trimethoprim for year daily
- 800mg sulfamethoxazole daily for year
- Prior to AB course, 2 week of streptomycin and penicillin or ceftriaxone
7
Q
Risks for whipples disease?
A
Relapse = 40% risk
