Name
WHIPPLES DISEASE
DESCRIPTION
DETAIL
D.D. : 1. INADEQUATE DIGESTION - POSTGASTRECTOMY - DEFICIENCY OR INACTIVATION OF PANCREATIC LIPASE - EXOCRINE PANCREATIC INSUFFICIENCY - CRO PANCREATITIS - PANCREATIC CARCINOMA - CYSTIC FIBROSIS - PANCREATIC INSUFFICIENCY- CONGENITAL OR ACQUIRED - GASTRINOMA - ACID INACTIVATION OF LIPASE - DRUGS LIKE ORLISTAT 2. REDUCED INTRADUODENAL BILE ACID CONCENTRATION / IMPAIRED MICELLE FORMATION -* LIVER DISEASES - PARENCHYMAL LIVER DISEASE - CHOLESTATIC LIVER DISEASE * BACTERIAL OVERGROUTH IN SMALL INTESTINE - ANATOMIC STASIS LIKE AFFERENT LOOP STASIS, BLIND LOOP STASIS, STRICTURE , FISTULA - FUNCTIONAL STASIS LIKE DIABETES , SCLERODERMA, INTESTINAL PSEUDOOBSTRUCTION * INTERRUPTED INTEROHEPATIC CIRCULATION OF BILE SALTS - ILEAL RESECTION - CROHNS DISEASE * DRUGS WHICH BIND OR PRECIPITATE BILE SALTS LIKE NEOMYCIN, CHOLESTYRAMINE, CAL CARBONATE 3. IMPAIRED MUCOSAL ABSORPTION / MUCOSAL LOSS OR DEFECT * INTESTINAL RESECTION OR BYPASS * INFLAMMATION, INFILTRATION OR INFECTION - CROHNS DISEASE - AMYLOIDOSIS - SCLERODERMA - LYMPHOMA - EOSINOPHILIC ENTERITIS - MASTOCYTOSIS - TROPICAL SPRUE - CELIAC DISEASE - COLLAGENOUS SPRUE - WIPPLES DISEASE - RADIATION ENTERITIS - FOLATE & VIT B12 DEFICIENCY - INFECTIONS LIKE SALMONELLA, GIARDIASIS - GRAFT VS HOST DISEASE * GENETIC DISEASES - DISACCHARIDASE DEFICIENCY - AGAMMAGLOBULINEMIA - ABETALIPOPROTEINEMIA - HARTNUP DISEASE - CYSTINURIA 4. IMPAIRED NUTRIENT DELIVERY TO AND / OR FROM INTESTINE * LYMPHATIC OBSTRUCTION - LYMPHOMA - LYMPHANGIECTASIA * CIRCULATORY DISORDERS - CONGESTIVE HEART FAILURE - CONSTRICTIVE PERICARDITIS - MESENTERIC ARTRY ATHEROSCLEROSIS - VASCULITIS 5. ENDOCRINE & METABOLIC DISORDERS - DIABETES - HYPOPARATHYROIDISM - ADRENAL INSUFFICIENCY - HYPERTHYROIDISM - CARCINOID SYNDROMEOTHER TESTS : * BIOPSY - PRESENCE OF PAS ( PERIODIC ACID SCHIFF ) POSITIVE MACROPHAGES CONTAINING BACILLI IN THE SMALL INTESTINE & OTHER ORGANS ( LIVER , LYMPH NODES , HEART , EYES , CNS , SYNOVIAL MEMBRANES ) WITH EVIDENCE OF DISEASE CAUSED BY GRAM POSITIVE BACILLI, T. WHIPPELII. PRESENCE OF T. WHIPPELII BACILLUS OUTSIDE OF MACROPHAGES IS MORE IMPORTANT INDICATOR OF ACTIVE DISEASE THAN THEIR PRESENCE IN THE MACROPHAGE.
TYPENOTES
Medical Care: The mainstay of medical treatment is antibiotic therapy. Surgical Care: Surgery is not part of the therapy for this disease. Diet: Usually, no dietary changes are required. Activity: Usually, no activity restrictions are required.
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
COMPLETE BLOOD COUNT, PCR, BIOPSY