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==Overview== | ==Overview== | ||
[[Small bowel]] [[biopsy]] may be helpful in the diagnosis of Whipple's disease. Diagnostic findings of Whipple's disease include, [[PAS stain|PAS]] positive [[inclusions]] in [[macrophages]] of [[lamina propria]]. Other diagnostic studies for Whipple's disease include [[electron microscopy]] which demonstrate [[bacteria]], [[immunofluorescent]] assay to detect [[antibodies]] against [[Tropheryma whipplei]] and [[PCR]], which demonstrates 16S [[rRNA]] gene of [[Tropheryma whipplei]]. | [[Endoscopy]] and [[Small intestine|small bowel]] [[biopsy]] may be helpful in the diagnosis of Whipple's disease. Diagnostic findings of Whipple's disease include, [[PAS stain|PAS]] positive [[inclusions]] in [[macrophages]] of [[lamina propria]]. Other diagnostic studies for Whipple's disease include [[electron microscopy]] which demonstrate [[bacteria]], [[immunofluorescent]] assay to detect [[antibodies]] against [[Tropheryma whipplei|''Tropheryma whipplei'']] and [[PCR]], which demonstrates 16S [[rRNA]] gene of [[Tropheryma whipplei|''Tropheryma whipplei'']]. | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
*[[ | *[[Endoscopy]] of the [[Intestines|intestine]] may show:<ref name="pmid11432814">{{cite journal| author=Dutly F, Altwegg M| title=Whipple's disease and "Tropheryma whippelii". | journal=Clin Microbiol Rev | year= 2001 | volume= 14 | issue= 3 | pages= 561-83 | pmid=11432814 | doi=10.1128/CMR.14.3.561-583.2001 | pmc=88990 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11432814 }} </ref><ref name="pmid17202456">{{cite journal| author=Fenollar F, Puéchal X, Raoult D| title=Whipple's disease. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 1 | pages= 55-66 | pmid=17202456 | doi=10.1056/NEJMra062477 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17202456 }} </ref><ref name="pmid18291339">{{cite journal |vauthors=Schneider T, Moos V, Loddenkemper C, Marth T, Fenollar F, Raoult D |title=Whipple's disease: new aspects of pathogenesis and treatment |journal=Lancet Infect Dis |volume=8 |issue=3 |pages=179–90 |year=2008 |pmid=18291339 |doi=10.1016/S1473-3099(08)70042-2 |url=}}</ref><ref name="MarthMoos2016">{{cite journal|last1=Marth|first1=Thomas|last2=Moos|first2=Verena|last3=Müller|first3=Christian|last4=Biagi|first4=Federico|last5=Schneider|first5=Thomas|title=Tropheryma whipplei infection and Whipple's disease|journal=The Lancet Infectious Diseases|volume=16|issue=3|year=2016|pages=e13–e22|issn=14733099|doi=10.1016/S1473-3099(15)00537-X}}</ref><ref name="Schoniger-HekelePetermann2007">{{cite journal|last1=Schoniger-Hekele|first1=M.|last2=Petermann|first2=D.|last3=Weber|first3=B.|last4=Muller|first4=C.|title=Tropheryma whipplei in the Environment: Survey of Sewage Plant Influxes and Sewage Plant Workers|journal=Applied and Environmental Microbiology|volume=73|issue=6|year=2007|pages=2033–2035|issn=0099-2240|doi=10.1128/AEM.02335-06}}</ref><ref name="BurešKopáčová2013">{{cite journal|last1=Bureš|first1=Jan|last2=Kopáčová|first2=Marcela|last3=Douda|first3=Tomáš|last4=Bártová|first4=Jolana|last5=Tomš|first5=Jan|last6=Rejchrt|first6=Stanislav|last7=Tachecí|first7=Ilja|title=Whipple’s Disease: Our Own Experience and Review of the Literature|journal=Gastroenterology Research and Practice|volume=2013|year=2013|pages=1–10|issn=1687-6121|doi=10.1155/2013/478349}}</ref><ref name="DutlyAltwegg2001">{{cite journal|last1=Dutly|first1=F.|last2=Altwegg|first2=M.|title=Whipple's Disease and "Tropheryma whippelii"|journal=Clinical Microbiology Reviews|volume=14|issue=3|year=2001|pages=561–583|issn=0893-8512|doi=10.1128/CMR.14.3.561-583.2001}}</ref><ref name="DolmansBoel2017">{{cite journal|last1=Dolmans|first1=Ruben A. V.|last2=Boel|first2=C. H. Edwin|last3=Lacle|first3=Miangela M.|last4=Kusters|first4=Johannes G.|title=Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections|journal=Clinical Microbiology Reviews|volume=30|issue=2|year=2017|pages=529–555|issn=0893-8512|doi=10.1128/CMR.00033-16}}</ref><ref name="pmid18159328">{{cite journal |vauthors=Conly JM, Johnston BL |title=Rare but not so rare: The evolving spectrum of Whipple's disease |journal=Can J Infect Dis |volume=12 |issue=3 |pages=133–5 |year=2001 |pmid=18159328 |pmc=2094813 |doi= |url=}}</ref><ref name="FenollarLagier2014">{{cite journal|last1=Fenollar|first1=Florence|last2=Lagier|first2=Jean-Christophe|last3=Raoult|first3=Didier|title=Tropheryma whipplei and Whipple's disease|journal=Journal of Infection|volume=69|issue=2|year=2014|pages=103–112|issn=01634453|doi=10.1016/j.jinf.2014.05.008}}</ref><ref name="KeitaBrouqui2013">{{cite journal|last1=Keita|first1=Alpha Kabinet|last2=Brouqui|first2=Philippe|last3=Badiaga|first3=Sékéné|last4=Benkouiten|first4=Samir|last5=Ratmanov|first5=Pavel|last6=Raoult|first6=Didier|last7=Fenollar|first7=Florence|title=Tropheryma whipplei prevalence strongly suggests human transmission in homeless shelters|journal=International Journal of Infectious Diseases|volume=17|issue=1|year=2013|pages=e67–e68|issn=12019712|doi=10.1016/j.ijid.2012.05.1033}}</ref><ref name="SchwartzmanSchwartzman2013">{{cite journal|last1=Schwartzman|first1=Sergio|last2=Schwartzman|first2=Monica|title=Whipple's Disease|journal=Rheumatic Disease Clinics of North America|volume=39|issue=2|year=2013|pages=313–321|issn=0889857X|doi=10.1016/j.rdc.2013.03.005}}</ref> | ||
**Thick circular folds | |||
**Erosions | |||
**[[Erythematous]] [[mucosa]] | |||
**Multiple whitish yellow small [[plaques]] | |||
*[[Small bowel]] [[biopsy]] may be helpful in the diagnosis of Whipple's disease. Findings diagnostic of Whipple's disease include: | |||
**[[PAS stain|PAS]] positive [[inclusions]] in [[macrophages]] of [[lamina propria]] | **[[PAS stain|PAS]] positive [[inclusions]] in [[macrophages]] of [[lamina propria]] | ||
**All the organs affected by disease may demonstrate [[Periodic acid-Schiff stain|PAS]] positive [[macrophages]] like [[heart]], [[lungs]], [[CNS]], [[eyes]], [[liver]], [[spleen]], [[joints]], and [[bone marrow]]. | **All the organs affected by disease may demonstrate [[Periodic acid-Schiff stain|PAS]] positive [[macrophages]] like [[heart]], [[lungs]], [[CNS]], [[eyes]], [[liver]], [[spleen]], [[joints]], and [[bone marrow]]. | ||
* Other diagnostic studies for [[Whipple's disease]] which confirm the diagnosis include: | * Other diagnostic studies for [[Whipple's disease]] which confirm the diagnosis include: | ||
**[[Electron microscopy]], which demonstrates: | **[[Electron microscopy]], which demonstrates: | ||
***Typical trilamellar [[membrane]] of [[Tropheryma whipplei]] | ***Typical trilamellar [[membrane]] of [[Tropheryma whipplei|''Tropheryma whipplei'']] which consists of: | ||
***Gram positive cell wall structure | ****[[Plasma membrane]] | ||
****Thin homogeneous wall | |||
****[[Plasma membrane]]–like structure | |||
***[[Gram positive]] [[cell wall]] structure | |||
**[[PCR]] of affected tissue, which demonstrates: | **[[PCR]] of affected tissue, which demonstrates: | ||
***16S [[rRNA]] gene of [[Tropheryma whipplei]] | ***16S [[rRNA]] gene of [[Tropheryma whipplei|''Tropheryma whipplei'']] | ||
** Serum [[immunofluorescent]] assay, which demonstrates: | ** Serum [[immunofluorescent]] assay, which demonstrates: | ||
***[[Antibodies]] against [[Tropheryma whipplei]] | ***[[Antibodies]] against [[Tropheryma whipplei|''Tropheryma whipplei'']] | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Infectious disease]] | |||
[[Category:Up-To-Date]] | |||
Latest revision as of 00:44, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Bhagyashree Deshmankar M.B.B.S.[2]; Sadaf Sharfaei M.D.[3]
Overview
Endoscopy and small bowel biopsy may be helpful in the diagnosis of Whipple's disease. Diagnostic findings of Whipple's disease include, PAS positive inclusions in macrophages of lamina propria. Other diagnostic studies for Whipple's disease include electron microscopy which demonstrate bacteria, immunofluorescent assay to detect antibodies against Tropheryma whipplei and PCR, which demonstrates 16S rRNA gene of Tropheryma whipplei.
Other Diagnostic Studies
- Endoscopy of the intestine may show:[1][2][3][4][5][6][7][8][9][10][11][12]
- Thick circular folds
- Erosions
- Erythematous mucosa
- Multiple whitish yellow small plaques
- Small bowel biopsy may be helpful in the diagnosis of Whipple's disease. Findings diagnostic of Whipple's disease include:
- PAS positive inclusions in macrophages of lamina propria
- All the organs affected by disease may demonstrate PAS positive macrophages like heart, lungs, CNS, eyes, liver, spleen, joints, and bone marrow.
- Other diagnostic studies for Whipple's disease which confirm the diagnosis include:
- Electron microscopy, which demonstrates:
- Typical trilamellar membrane of Tropheryma whipplei which consists of:
- Plasma membrane
- Thin homogeneous wall
- Plasma membrane–like structure
- Gram positive cell wall structure
- Typical trilamellar membrane of Tropheryma whipplei which consists of:
- PCR of affected tissue, which demonstrates:
- 16S rRNA gene of Tropheryma whipplei
- Serum immunofluorescent assay, which demonstrates:
- Antibodies against Tropheryma whipplei
- Electron microscopy, which demonstrates:
References
- ↑ Dutly F, Altwegg M (2001). "Whipple's disease and "Tropheryma whippelii"". Clin Microbiol Rev. 14 (3): 561–83. doi:10.1128/CMR.14.3.561-583.2001. PMC 88990. PMID 11432814.
- ↑ Fenollar F, Puéchal X, Raoult D (2007). "Whipple's disease". N Engl J Med. 356 (1): 55–66. doi:10.1056/NEJMra062477. PMID 17202456.
- ↑ Schneider T, Moos V, Loddenkemper C, Marth T, Fenollar F, Raoult D (2008). "Whipple's disease: new aspects of pathogenesis and treatment". Lancet Infect Dis. 8 (3): 179–90. doi:10.1016/S1473-3099(08)70042-2. PMID 18291339.
- ↑ Marth, Thomas; Moos, Verena; Müller, Christian; Biagi, Federico; Schneider, Thomas (2016). "Tropheryma whipplei infection and Whipple's disease". The Lancet Infectious Diseases. 16 (3): e13–e22. doi:10.1016/S1473-3099(15)00537-X. ISSN 1473-3099.
- ↑ Schoniger-Hekele, M.; Petermann, D.; Weber, B.; Muller, C. (2007). "Tropheryma whipplei in the Environment: Survey of Sewage Plant Influxes and Sewage Plant Workers". Applied and Environmental Microbiology. 73 (6): 2033–2035. doi:10.1128/AEM.02335-06. ISSN 0099-2240.
- ↑ Bureš, Jan; Kopáčová, Marcela; Douda, Tomáš; Bártová, Jolana; Tomš, Jan; Rejchrt, Stanislav; Tachecí, Ilja (2013). "Whipple's Disease: Our Own Experience and Review of the Literature". Gastroenterology Research and Practice. 2013: 1–10. doi:10.1155/2013/478349. ISSN 1687-6121.
- ↑ Dutly, F.; Altwegg, M. (2001). "Whipple's Disease and "Tropheryma whippelii"". Clinical Microbiology Reviews. 14 (3): 561–583. doi:10.1128/CMR.14.3.561-583.2001. ISSN 0893-8512.
- ↑ Dolmans, Ruben A. V.; Boel, C. H. Edwin; Lacle, Miangela M.; Kusters, Johannes G. (2017). "Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections". Clinical Microbiology Reviews. 30 (2): 529–555. doi:10.1128/CMR.00033-16. ISSN 0893-8512.
- ↑ Conly JM, Johnston BL (2001). "Rare but not so rare: The evolving spectrum of Whipple's disease". Can J Infect Dis. 12 (3): 133–5. PMC 2094813. PMID 18159328.
- ↑ Fenollar, Florence; Lagier, Jean-Christophe; Raoult, Didier (2014). "Tropheryma whipplei and Whipple's disease". Journal of Infection. 69 (2): 103–112. doi:10.1016/j.jinf.2014.05.008. ISSN 0163-4453.
- ↑ Keita, Alpha Kabinet; Brouqui, Philippe; Badiaga, Sékéné; Benkouiten, Samir; Ratmanov, Pavel; Raoult, Didier; Fenollar, Florence (2013). "Tropheryma whipplei prevalence strongly suggests human transmission in homeless shelters". International Journal of Infectious Diseases. 17 (1): e67–e68. doi:10.1016/j.ijid.2012.05.1033. ISSN 1201-9712.
- ↑ Schwartzman, Sergio; Schwartzman, Monica (2013). "Whipple's Disease". Rheumatic Disease Clinics of North America. 39 (2): 313–321. doi:10.1016/j.rdc.2013.03.005. ISSN 0889-857X.