Sandbox: wdx

Whipple's disease Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

[Pathogen name] is usually transmitted via the [transmission route] route to the human host. Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell. [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells]. The progression to [disease name] usually involves the [molecular pathway]. The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

• Whipple's disease is a rare bacterial systemic infection caused by Tropheryma whipplei.

• Tropheryma whipplei is a periodic acid-Schiff stain positive, gram-positive bacillus of actinomycetes family.

• The bacteria lives in soil and wastewater. Farmers and everyone who has any contact with contaminated soil and water are in high risk of the infection.

• It is transmitted through oro-oral and feco-oral routes. The poor sanitation is associated with T. whipplei infection. 

• It is believed that human being is the only reservoir for this bacteria.

• It invades primarily intestines and then every other organ including the heart, CNS, joints, lymph nodes, skin, lungs and the eyes.

• Tropheryma whipplei infection has four different manifestations: acute infection, the classic Whipple’s disease, asymptomatic carrier state, and localized chronic infection.

• It is believed that host immunologic response to the microorganism plays an important role on the clinical manifestation of the disease.

Genetics

• [Disease name] is transmitted in [mode of genetic transmission] pattern.
• Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
• The development of [disease name] is the result of multiple genetic mutations.

Associated Conditions

The most important conditions associated with Whipple's disease include:

• HLA-B27 individuals:
• Defective T-cell immunity:

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, PAS-positive macrophages in the lamina propria containing non-acid-fast gram-positive bacilli are characteristic findings of Whipple's disease.

The images show the characteristic feature of Whipple's disease; foamy macrophages are present in the lamina propria.

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  Low magnification micrograph of Whipple's disease. H&E stain. Duodenal biopsy. By Nephron (Own work)

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  Intermediate magnification micrograph of Whipple's disease. H&E stain. Duodenal biopsy. By Nephron (Own work)

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  High magnification micrograph of Whipple's disease. H&E stain. Duodenal biopsy. By Nephron (Own work)

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  Very high magnification micrograph of Whipple's disease. H&E stain. Duodenal biopsy. By Nephron (Own work)