Whipple's disease classification: Difference between revisions

	Whipple's disease Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Whipple's disease from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Whipple's disease classification On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Whipple's disease classification All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Whipple's disease classification
CDC on Whipple's disease classification
Whipple's disease classification in the news
Blogs on Whipple's disease classification
Directions to Hospitals Treating Whipple's disease
Risk calculators and risk factors for Whipple's disease classification

← Older edit Newer edit →

VisualWikitext

Revision as of 15:18, 12 November 2017

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 2 groups of acute and chronic infection. It might be classified as systemic or localized based on the organ involvement. It has 4 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.^[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 2 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 4 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 8: / Line 8: @@
 ==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>
+<br>
+'''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 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>
+'''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]] [[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>
 **[[Acute]] [[infections]] such as:
@@ 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==

Whipple's disease classification: Difference between revisions

Revision as of 15:18, 12 November 2017

Overview

Classification

References

Navigation menu

Search