Last reviewed: November 2017
Last updated: August  2017

Summary

Definition

History and exam

Key diagnostic factors

  • diarrhea
  • weight loss
  • arthralgia
  • supranuclear ophthalmoplegia

Other diagnostic factors

  • abdominal pain
  • lymphadenopathy
  • fever
  • steatorrhea
  • skin darkening
  • confusion, memory impairment, altered level of consciousness, or dementia
  • apathy
  • anxiety, depression, hypomania, psychosis, change in personality
  • myoclonic signs
  • seizures
  • nystagmus
  • brisk reflexes, extensor plantar responses, weakness predominating in arm extensors and leg flexors, hypertonia
  • amenorrhea, polydipsia, hyperphagia, decreased libido
  • ataxia
  • headaches
  • oculomasticatory and oculofacioskeletal myorhythmias
  • hemiparesis
  • cranial nerve involvement
  • extrapyramidal movement disorder
  • peripheral neuropathies

Risk factors

  • age >50 years
  • male gender
  • genetic factors

Diagnostic investigations

1st investigations to order

  • CBC
  • serum albumin
  • serum CRP
  • serum ESR
  • upper GI endoscopy
  • Periodic acid-Schiff (PAS) staining of duodenal biopsies
  • PCR
  • Tropheryma whipplei-specific immunohistochemistry
Full details

Emerging tests

  • electron microscopy
  • culture
  • serology
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor

Medical Department I

Charité - University Medicine Berlin

CBF

Berlin

Germany

Disclosures

TS is an author of a number of references cited in this monograph.

Scientist

Medical Department I

Charité - University Medicine Berlin

CBF

Berlin

Germany

Disclosures

VM is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Professor of Medicine

Department of Microbiology and Immunology

Albert Einstein College of Medicine

Bronx

NY

Disclosures

SGB declares that he has no competing interests.

Assistant Professor of Medicine

Division of Infectious Diseases

University of Vermont

Burlington

VT

Disclosures

CH declares that he has no competing interests.

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