Last reviewed: July 2020
Last updated: April  2020

Summary

Definition

History and exam

Key diagnostic factors

  • diarrhea
  • weight loss
  • arthralgia
  • supranuclear ophthalmoplegia

Other diagnostic factors

  • abdominal pain
  • lymphadenopathy
  • fever
  • steatorrhea
  • anemia
  • 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 sex
  • 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
More 1st investigations to order

Emerging tests

  • electron microscopy
  • culture
  • serology
More emerging tests

Treatment algorithm

Contributors

Professor

Medical Department I

Charité - University Medicine Berlin

CBF

Berlin

Germany

Disclosures

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

Scientist

Medical Department I

Charité - University Medicine Berlin

CBF

Berlin

Germany

Disclosures

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

Peer reviewersVIEW 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.

Use of this content is subject to our disclaimer