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Whipple's disease classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Whipple’s disease may be classified into two groups of acute and chronic infection. It might be classified as systemic or localized based on the organ involvement. It has four different clinical manifestations: Acute infection, asymptomatic carrier state, the classic Whipple’s disease, and localized chronic infection.

Classification

  • Whipple’s disease may be classified to two groups of acute and chronic based on the duration.[1][2]


Whipple’s disease classification based on the duration:

 
 
 
 
 
 
 
 
 
 
 
 
 
Whipple’s disease classification
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acute
 
 
 
 
 
 
 
Chronic
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gastroenteritis
 
Pneumonia
 
Bacteremia
 
Asymptomatic carrier state
 
 
Classic Whipple’s disease
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chronic localized infection
 
 
 
 
 
 



Whipple’s disease classification based on organ involvement:

 
 
 
 
 
 
 
 
Whipple’s disease classification
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Systemic involvement
 
 
 
 
 
 
 
 
 
 
 
 
 
Localized involvement
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Heart
 
CNS
 
Eye
 
Lung
 
Bone
 
Serosa
 
Skin
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Blood culture negative endocarditis
• Adhesive pericarditis
Myocardial fibrosis
 
Encephalitis
• Progressive dementia
Cerebellar ataxia
Personality changes
Hemiparesis
Seizure
Wernicke’s encephalopathy
Hypothalamic involvement
Supranuclear ophthalmoplegia
 
Uveitis
Vitritis
Retinitis
Retrobulbar neuritis
Papilledema
 
• Chronic cough
Dyspnea
 
Arthritis
Spondylodiscitis
 
Pleuritic chest pain
 
Hyperpigmentation
 
 



References

  1. 1.0 1.1 Marth, Thomas (2009). “New Insights into Whipple’s Disease – A Rare Intestinal Inflammatory Disorder”. Digestive Diseases. 27 (4): 494–501. doi:10.1159/000233288. ISSN 1421-9875.
  2. Schneider, Thomas; Moos, Verena; Loddenkemper, Christoph; Marth, Thomas; Fenollar, Florence; Raoult, Didier (2008). “Whipple’s disease: new aspects of pathogenesis and treatment”. The Lancet Infectious Diseases. 8 (3): 179–190. doi:10.1016/S1473-3099(08)70042-2. ISSN 1473-3099.
  3. Relman, David A.; Schmidt, Thomas M.; MacDermott, Richard P.; Falkow, Stanley (1992). “Identification of the Uncultured Bacillus of Whipple’s Disease”. New England Journal of Medicine. 327 (5): 293–301. doi:10.1056/NEJM199207303270501. ISSN 0028-4793.
  4. Street, Sara; Donoghue, Helen D; Neild, GH (1999). “Tropheryma whippelii DNA in saliva of healthy people”. The Lancet. 354 (9185): 1178–1179. doi:10.1016/S0140-6736(99)03065-2. ISSN 0140-6736.
  5. Ectors N, Geboes K, De Vos R, Heidbuchel H, Rutgeerts P, Desmet V, Vantrappen G (1992). “Whipple’s disease: a histological, immunocytochemical and electronmicroscopic study of the immune response in the small intestinal mucosa”. Histopathology. 21 (1): 1–12. PMID 1378814.
  6. Marth T, Strober W (1996). “Whipple’s disease”. Semin. Gastrointest. Dis. 7 (1): 41–8. PMID 8903578.

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