Sandbox: wdx

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
Sandbox: wdx On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sandbox: wdx All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sandbox: wdx
CDC on Sandbox: wdx
Sandbox: wdx in the news
Blogs on Sandbox: wdx
Directions to Hospitals Treating Whipple's disease
Risk calculators and risk factors for Sandbox: wdx

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 bacterium lives in soil and wastewater. Farmers and everyone who has any contact with contaminated soil and water are at 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 bacterium.

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

• Tissues are infected by macrophage infiltration contaminated by Tropheryma whipplei. T. whipplei multiplies in macrophages and monocytes.

• Tropheryma whipplei infection causes four different clinical 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

There is no known causative genetic factor for Whipple's disease. However, there is an association between Whipple's disease and some immunologic defects.

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.

• 

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

• 

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

• 

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

• 

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