Last reviewed: 30 Aug 2023
Last updated: 20 Sep 2023
Summary
Definition
History and exam
Key diagnostic factors
- diarrhea
- weight loss
- arthralgia
- supranuclear ophthalmoplegia
More key diagnostic factors
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
Other diagnostic factors
Risk factors
- age >50 years
- male sex
- genetic factors
More risk 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
Treatment algorithm
ACUTE
patients without CNS involvement
patients with CNS involvement
Contributors
Authors
Thomas Schneider, MD, PhD
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.
Verena Moos, PhD
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 reviewers
Stephen G. Baum, MD
Professor of Medicine
Department of Microbiology and Immunology
Albert Einstein College of Medicine
Bronx
NY
Disclosures
SGB declares that he has no competing interests.
Chris Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont
Burlington
VT
Disclosures
CH declares that he has no competing interests.
Differentials
- Seronegative rheumatoid arthritis
- Sarcoidosis
- Celiac disease
More DifferentialsPatient leaflets
Diarrhea in adults
Diarrhea in children
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