Whipple's disease classification: Difference between revisions

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Latest revision as of 00:44, 30 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Whipple’s disease may be classified into two groups of acute and chronic infection. It might be classified as systemic or localized based on the organ involvement. It has four different clinical manifestations: Acute infection, asymptomatic carrier state, the classic Whipple’s disease, and localized chronic infection.

Classification

Whipple's disease may be classified to two groups of acute and chronic based on the duration.^[1]^[2]

Whipple's disease classification based on the duration:

Whipple's disease classification

Acute

Chronic

Gastroenteritis

Pneumonia

Bacteremia

Asymptomatic carrier state

Classic Whipple's disease

Chronic localized infection

Whipple's disease may be classified to two groups of systemic and localized infection based on organ involvement.^[3]

Whipple's disease classification based on organ involvement:

Whipple's disease classification

Systemic involvement

Localized involvement

• Blood culture negative endocarditis
• Adhesive pericarditis
• Myocardial fibrosis

• Encephalitis
• Progressive dementia
• Cerebellar ataxia
• Personality changes
• Hemiparesis
• Seizure
• Wernicke’s encephalopathy
• Hypothalamic involvement
• Supranuclear ophthalmoplegia

• Uveitis
• Vitritis
• Retinitis
• Retrobulbar neuritis
• Papilledema

• Chronic cough
• Dyspnea

• Arthritis
• Spondylodiscitis

• Pleuritic chest pain

• Hyperpigmentation

Tropheryma whipplei infection may be classified to four groups based on the clinical manifestation:^[1]^[4]^[5]^[6]
- Acute infections such as:
- Asymptomatic carrier state
- The classic Whipple’s disease
- Localized involvement of different organs including:
  - Heart:
    - Blood-culture negative endocarditis
    - Adhesive pericarditis
    - Myocardial fibrosis
  - CNS:
    - Encephalitis
    - Progressive dementia
    - Cerebellar ataxia
    - Personality changes
    - Hemiparesis
    - Seizure
    - Wernicke’s encephalopathy
    - Hypothalamic involvement
    - Supranuclear ophthalmoplegia
  - Eyes:
    - Uveitis
    - Vitritis
    - Retinitis
    - Retrobulbar neuritis
    - Papilledema
  - Lung:
    - Chronic cough
    - Dyspnea
  - Bone:
    - Arthritis
    - Spondylodiscitis
  - Serosa:
    - Pleuritic chest pain
  - Skin:
    - Hyperpigmentation

References

↑ ^1.0 ^1.1 Marth, Thomas (2009). "New Insights into Whipple's Disease – A Rare Intestinal Inflammatory Disorder". Digestive Diseases. 27 (4): 494–501. doi:10.1159/000233288. ISSN 1421-9875.
↑ Schneider, Thomas; Moos, Verena; Loddenkemper, Christoph; Marth, Thomas; Fenollar, Florence; Raoult, Didier (2008). "Whipple's disease: new aspects of pathogenesis and treatment". The Lancet Infectious Diseases. 8 (3): 179–190. doi:10.1016/S1473-3099(08)70042-2. ISSN 1473-3099.
↑ Relman, David A.; Schmidt, Thomas M.; MacDermott, Richard P.; Falkow, Stanley (1992). "Identification of the Uncultured Bacillus of Whipple's Disease". New England Journal of Medicine. 327 (5): 293–301. doi:10.1056/NEJM199207303270501. ISSN 0028-4793.
↑ Street, Sara; Donoghue, Helen D; Neild, GH (1999). "Tropheryma whippelii DNA in saliva of healthy people". The Lancet. 354 (9185): 1178–1179. doi:10.1016/S0140-6736(99)03065-2. ISSN 0140-6736.
↑ Ectors N, Geboes K, De Vos R, Heidbuchel H, Rutgeerts P, Desmet V, Vantrappen G (1992). "Whipple's disease: a histological, immunocytochemical and electronmicroscopic study of the immune response in the small intestinal mucosa". Histopathology. 21 (1): 1–12. PMID 1378814.
↑ Marth T, Strober W (1996). "Whipple's disease". Semin. Gastrointest. Dis. 7 (1): 41–8. PMID 8903578.

Template:WH Template:WS

[Marth2009-1] 1.0 ^1.1 Marth, Thomas (2009). "New Insights into Whipple's Disease – A Rare Intestinal Inflammatory Disorder". Digestive Diseases. 27 (4): 494–501. doi:10.1159/000233288. ISSN 1421-9875.

[SchneiderMoos2008-2] Schneider, Thomas; Moos, Verena; Loddenkemper, Christoph; Marth, Thomas; Fenollar, Florence; Raoult, Didier (2008). "Whipple's disease: new aspects of pathogenesis and treatment". The Lancet Infectious Diseases. 8 (3): 179–190. doi:10.1016/S1473-3099(08)70042-2. ISSN 1473-3099.

[RelmanSchmidt1992-3] Relman, David A.; Schmidt, Thomas M.; MacDermott, Richard P.; Falkow, Stanley (1992). "Identification of the Uncultured Bacillus of Whipple's Disease". New England Journal of Medicine. 327 (5): 293–301. doi:10.1056/NEJM199207303270501. ISSN 0028-4793.

[StreetDonoghue1999-4] Street, Sara; Donoghue, Helen D; Neild, GH (1999). "Tropheryma whippelii DNA in saliva of healthy people". The Lancet. 354 (9185): 1178–1179. doi:10.1016/S0140-6736(99)03065-2. ISSN 0140-6736.

[pmid1378814-5] Ectors N, Geboes K, De Vos R, Heidbuchel H, Rutgeerts P, Desmet V, Vantrappen G (1992). "Whipple's disease: a histological, immunocytochemical and electronmicroscopic study of the immune response in the small intestinal mucosa". Histopathology. 21 (1): 1–12. PMID 1378814.

[pmid8903578-6] Marth T, Strober W (1996). "Whipple's disease". Semin. Gastrointest. Dis. 7 (1): 41–8. PMID 8903578.

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 4: / Line 4: @@
 ==Overview==
-Whipple’s disease may be classified into 2 groups of [[acute]] and [[chronic]] [[infection]]. It might be classified as [[systemic]] or localized based on the [[Organ (biology)|organ]] involvement. It has 4 different [[clinical]] manifestations: [[Acute]] [[infection]], [[asymptomatic carrier]] state, the classic Whipple’s disease, and localized [[chronic]] [[infection]].
+Whipple’s disease may be classified into two groups of [[acute]] and [[chronic]] [[infection]]. It might be classified as [[systemic]] or localized based on the [[Organ (biology)|organ]] involvement. It has four different [[clinical]] manifestations: [[Acute]] [[infection]], [[asymptomatic carrier]] state, the classic Whipple’s disease, and localized [[chronic]] [[infection]].
 ==Classification==
-*Whipple's disease may be classified to 2 groups of [[acute]] and [[chronic]] based on the duration.<ref name="Marth2009">{{cite journal|last1=Marth|first1=Thomas|title=New Insights into Whipple’s Disease – A Rare Intestinal Inflammatory Disorder|journal=Digestive Diseases|volume=27|issue=4|year=2009|pages=494–501|issn=1421-9875|doi=10.1159/000233288}}</ref><ref name="SchneiderMoos2008">{{cite journal|last1=Schneider|first1=Thomas|last2=Moos|first2=Verena|last3=Loddenkemper|first3=Christoph|last4=Marth|first4=Thomas|last5=Fenollar|first5=Florence|last6=Raoult|first6=Didier|title=Whipple's disease: new aspects of pathogenesis and treatment|journal=The Lancet Infectious Diseases|volume=8|issue=3|year=2008|pages=179–190|issn=14733099|doi=10.1016/S1473-3099(08)70042-2}}</ref>
+*Whipple's disease may be classified to two groups of [[acute]] and [[chronic]] based on the duration.<ref name="Marth2009">{{cite journal|last1=Marth|first1=Thomas|title=New Insights into Whipple’s Disease – A Rare Intestinal Inflammatory Disorder|journal=Digestive Diseases|volume=27|issue=4|year=2009|pages=494–501|issn=1421-9875|doi=10.1159/000233288}}</ref><ref name="SchneiderMoos2008">{{cite journal|last1=Schneider|first1=Thomas|last2=Moos|first2=Verena|last3=Loddenkemper|first3=Christoph|last4=Marth|first4=Thomas|last5=Fenollar|first5=Florence|last6=Raoult|first6=Didier|title=Whipple's disease: new aspects of pathogenesis and treatment|journal=The Lancet Infectious Diseases|volume=8|issue=3|year=2008|pages=179–190|issn=14733099|doi=10.1016/S1473-3099(08)70042-2}}</ref>
-*Whipple's disease may be classified to 2 groups of [[systemic]] and localized [[infection]] based on [[Organ (biology)|organ]] involvement.<ref name="RelmanSchmidt1992">{{cite journal|last1=Relman|first1=David A.|last2=Schmidt|first2=Thomas M.|last3=MacDermott|first3=Richard P.|last4=Falkow|first4=Stanley|title=Identification of the Uncultured Bacillus of Whipple's Disease|journal=New England Journal of Medicine|volume=327|issue=5|year=1992|pages=293–301|issn=0028-4793|doi=10.1056/NEJM199207303270501}}</ref>
+<br>
-*[[Tropheryma whipplei]] [[infection]] may be classified to 4 groups based on the [[clinical]] manifestation:<ref name="Marth2009">{{cite journal|last1=Marth|first1=Thomas|title=New Insights into Whipple’s Disease – A Rare Intestinal Inflammatory Disorder|journal=Digestive Diseases|volume=27|issue=4|year=2009|pages=494–501|issn=1421-9875|doi=10.1159/000233288}}</ref><ref name="StreetDonoghue1999">{{cite journal|last1=Street|first1=Sara|last2=Donoghue|first2=Helen D|last3=Neild|first3=GH|title=Tropheryma whippelii DNA in saliva of healthy people|journal=The Lancet|volume=354|issue=9185|year=1999|pages=1178–1179|issn=01406736|doi=10.1016/S0140-6736(99)03065-2}}</ref><ref name="pmid1378814">{{cite journal |vauthors=Ectors N, Geboes K, De Vos R, Heidbuchel H, Rutgeerts P, Desmet V, Vantrappen G |title=Whipple's disease: a histological, immunocytochemical and electronmicroscopic study of the immune response in the small intestinal mucosa |journal=Histopathology |volume=21 |issue=1 |pages=1–12 |year=1992 |pmid=1378814 |doi= |url=}}</ref><ref name="pmid8903578">{{cite journal |vauthors=Marth T, Strober W |title=Whipple's disease |journal=Semin. Gastrointest. Dis. |volume=7 |issue=1 |pages=41–8 |year=1996 |pmid=8903578 |doi= |url=}}</ref>
+'''Whipple's disease classification based on the duration:'''
+<br>
+{| align="center"
+|-
+|
+{{familytree/start}}
+{{familytree | | | | | | | | | | | | | | A01 | | | | | | | | | | | |A01=Whipple's disease classification}}
+{{familytree | | | | | | | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | | | |}}
+{{familytree | | | | | | | | | B01 | | | | | | | | B02 | | | | | | |B01=Acute|B02=Chronic}}
+{{familytree | | | | | |,|-|-|-|+|-|-|-|.| | | |,|-|+|-|.| | | | | |}}
+{{familytree | | | | | C01 | | C02 | | C03 | | C04 |!| C05 | | | | |C01=[[Gastroenteritis]]|C02=[[Pneumonia]]|C03=[[Bacteremia]]|C04=[[Asymptomatic carrier]] state|C05=Classic Whipple's disease}}
+{{familytree | | | | | | | | | | | | | | | | | | | |!| | | | | | | |}}
+{{familytree | | | | | | | | | | | | | | | | | | | D01 | | | | | | |D01=[[Chronic]] localized [[infection]]}}
+{{familytree/end}}
+|}
+<br>
+*Whipple's disease may be classified to two groups of [[systemic]] and localized [[infection]] based on [[Organ (biology)|organ]] involvement.<ref name="RelmanSchmidt1992">{{cite journal|last1=Relman|first1=David A.|last2=Schmidt|first2=Thomas M.|last3=MacDermott|first3=Richard P.|last4=Falkow|first4=Stanley|title=Identification of the Uncultured Bacillus of Whipple's Disease|journal=New England Journal of Medicine|volume=327|issue=5|year=1992|pages=293–301|issn=0028-4793|doi=10.1056/NEJM199207303270501}}</ref>
+<br>
+'''Whipple's disease classification based on [[organ]] involvement:'''
+<br><br>
+{| align="center"
+|-
+|
+{{familytree/start}}
+{{familytree | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | |A01=Whipple's disease classification}}
+{{familytree | |,|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | | | | | | | | | | | | |}}
+{{familytree | B01 | | | | | | | | | | | | | | B02 | | | | | | | | | | | | | | | | |B01=Systemic involvement|B02=Localized involvement}}
+{{familytree | | | | | |,|-|-|-|v|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|v|-|-|-|.| | | |}}
+{{familytree | | | | | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | | |C01=[[Heart]]|C02=[[CNS]]|C03=[[Eye]]|C04=[[Lung]]|C05=[[Bone]]|C06=[[Serosa]]|C07=[[Skin]]}}
+{{familytree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |}}
+{{familytree |boxstyle=text-align: left;| | | | | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | | |D01=• [[Blood culture]] negative [[endocarditis]]<br>• Adhesive [[pericarditis]]<br>• [[Myocardial]] [[fibrosis]]
+|D02=• [[Encephalitis]]<br>• Progressive [[dementia]]<br>• [[Cerebellar ataxia]]<br>• [[Personality changes]]<br>• [[Hemiparesis]]<br>• [[Seizure]]<br>• [[Wernicke’s encephalopathy]]<br>• [[Hypothalamic]] involvement<br>• [[Supranuclear ophthalmoplegia]]|D03=• [[Uveitis]]<br>• [[Vitritis]]<br>• [[Retinitis]]<br>• [[Retrobulbar neuritis]]<br>• [[Papilledema]]|D04=• Chronic [[cough]]<br>• [[Dyspnea]]|D05=• [[Arthritis]]<br>• [[Spondylodiscitis]]|D06=• [[Pleuritic chest pain]]|D07=• [[Hyperpigmentation]]}}
+{{familytree/end}}
+|}
+<br>
+*[[Tropheryma whipplei|''Tropheryma whipplei'']] [[infection]] may be classified to four groups based on the [[clinical]] manifestation:<ref name="Marth2009">{{cite journal|last1=Marth|first1=Thomas|title=New Insights into Whipple’s Disease – A Rare Intestinal Inflammatory Disorder|journal=Digestive Diseases|volume=27|issue=4|year=2009|pages=494–501|issn=1421-9875|doi=10.1159/000233288}}</ref><ref name="StreetDonoghue1999">{{cite journal|last1=Street|first1=Sara|last2=Donoghue|first2=Helen D|last3=Neild|first3=GH|title=Tropheryma whippelii DNA in saliva of healthy people|journal=The Lancet|volume=354|issue=9185|year=1999|pages=1178–1179|issn=01406736|doi=10.1016/S0140-6736(99)03065-2}}</ref><ref name="pmid1378814">{{cite journal |vauthors=Ectors N, Geboes K, De Vos R, Heidbuchel H, Rutgeerts P, Desmet V, Vantrappen G |title=Whipple's disease: a histological, immunocytochemical and electronmicroscopic study of the immune response in the small intestinal mucosa |journal=Histopathology |volume=21 |issue=1 |pages=1–12 |year=1992 |pmid=1378814 |doi= |url=}}</ref><ref name="pmid8903578">{{cite journal |vauthors=Marth T, Strober W |title=Whipple's disease |journal=Semin. Gastrointest. Dis. |volume=7 |issue=1 |pages=41–8 |year=1996 |pmid=8903578 |doi= |url=}}</ref>
 **[[Acute]] [[infections]] such as:
 ***[[Gastroenteritis]]
@@ Line 47: / Line 85: @@
 ***[[Skin]]:
 ****[[Hyperpigmentation]]
-<br>
-'''Whipple's disease classification based on the duration'''
-<br>
-<br>
-{| align="center"
-|-
-|
-{{familytree/start}}
-{{familytree | | | | | | | | | | | | | | A01 | | | | | | | | | | | |A01=Whipple's disease classification}}
-{{familytree | | | | | | | | | |,|-|-|-|-|^|-|-|-|-|.| | | | | | | |}}
-{{familytree | | | | | | | | | B01 | | | | | | | | B02 | | | | | | |B01=Acute|B02=Chronic}}
-{{familytree | | | | | |,|-|-|-|+|-|-|-|.| | | |,|-|+|-|.| | | | | |}}
-{{familytree | | | | | C01 | | C02 | | C03 | | C04 |!| C05 | | | | |C01=[[Gastroenteritis]]|C02=[[Pneumonia]]|C03=[[Bacteremia]]|C04=[[Asymptomatic carrier]] state|C05=Classic Whipple's disease}}
-{{familytree | | | | | | | | | | | | | | | | | | | |!| | | | | | | |}}
-{{familytree | | | | | | | | | | | | | | | | | | | D01 | | | | | | |D01=[[Chronic]] localized [[infection]]}}
-{{familytree/end}}
-|}
-<br>
-<br>
-'''Whipple's disease classification based on [[organ]] involvement'''
-<br><br>
-<br>
-{| align="center"
-|-
-|
-{{familytree/start}}
-{{familytree | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | |A01=Whipple's disease classification}}
-{{familytree | |,|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | | | | | | | | | | | | |}}
-{{familytree | B01 | | | | | | | | | | | | | | B02 | | | | | | | | | | | | | | | | |B01=Systemic involvement|B02=Localized involvement}}
-{{familytree | | | | | |,|-|-|-|v|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|v|-|-|-|.| | | |}}
-{{familytree | | | | | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | | |C01=[[Heart]]|C02=[[CNS]]|C03=[[Eye]]|C04=[[Lung]]|C05=[[Bone]]|C06=[[Serosa]]|C07=[[Skin]]}}
-{{familytree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | |}}
-{{familytree |boxstyle=text-align: left;| | | | | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | | |D01=• [[Blood culture]] negative [[endocarditis]]<br>• Adhesive [[pericarditis]]<br>• [[Myocardial fibrosis]]
-|D02=• [[Encephalitis]]<br>• Progressive [[dementia]]<br>• [[Cerebellar ataxia]]<br>• [[Personality changes]]<br>• [[Hemiparesis]]<br>• [[Seizure]]<br>• [[Wernicke’s encephalopathy]]<br>• [[Hypothalamic]] involvement<br>• [[Supranuclear ophthalmoplegia]]|D03=• [[Uveitis]]<br>• [[Vitritis]]<br>• [[Retinitis]]<br>• [[Retrobulbar neuritis]]<br>• [[Papilledema]]|D04=• Chronic [[cough]]<br>• [[Dyspnea]]|D05=• [[Arthritis]]<br>• [[Spondylodiscitis]]|D06=• [[Pleuritic chest pain]]|D07=• [[Hyperpigmentation]]}}
-{{familytree/end}}
-|}
-<br>
-<br>
 ==References==
 {{Reflist|2}}
 {{WH}}
 {{WS}}
+[[Category:Medicine]]
+[[Category:Gastroenterology]]
+[[Category:Infectious disease]]
+[[Category:Up-To-Date]]

Whipple's disease classification: Difference between revisions

Latest revision as of 00:44, 30 July 2020

Overview

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References

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