DR Medhat MRCP

Whipple`s disease
- It`s a rare multi-system disorder caused by bacillus named (Tropheryma Whipplii)
affecting mainly small bowel (causing malabsorption) & to less extent brain ,heart
,lungs ,joints &eyes .
- It is more common in those who are HLA-B27 positive and in middle-aged men.
• Features:
1) Malabsorption: diarrhoea, weight loss.
2) Large-joint arthralgia.
3) Lymphadenopathy.
4) Skin: hyperpigmentation and photosensitivity.
5) Pleurisy, pericarditis.
6) Neurological symptoms (rare): ophthalmoplegia, dementia, seizures, ataxia,
myoclonus
• Investigation:
Jejunal biopsy shows deposition of macrophages containing Periodic acid-Schiff (PAS)
granules .
• Management:
Varies e.g. IV penicillin then oral co-trimoxazole for a year
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