Whipple's disease differential diagnosis: Difference between revisions

Jump to navigation Jump to search
(Undo revision 1379535 by Ssharfaei (talk))
Line 24: Line 24:
{| class="wikitable"
{| class="wikitable"
! rowspan="2" |Cause
! rowspan="2" |Cause
! colspan="2" |Osmotic gap
! rowspan="2" |History
! rowspan="2" |History
! rowspan="2" |Physical exam
! rowspan="2" |Physical exam
Line 30: Line 29:
! rowspan="2" |Treatment
! rowspan="2" |Treatment
|-
|-
!< 50
mOsm


per kg
!> 50
mOsm
per kg*
|-
|-
|[[lactose intolerance]]
|[[lactose intolerance]]
| -
| +
|
|
* [[Bloating|Bloating,]]
* [[Bloating|Bloating,]]
Line 57: Line 47:
|-
|-
|[[Celiac sprue]]
|[[Celiac sprue]]
| -
| +
|
|
* [[Diarrhea]] with bulky, [[Steatorrhea|foul-smelling stools]]
* [[Diarrhea]] with bulky, [[Steatorrhea|foul-smelling stools]]
Line 79: Line 67:
|-
|-
|[[Whipple's disease|Whipple disease]]
|[[Whipple's disease|Whipple disease]]
| -
| +
|
|
* [[Arthralgias]]
* [[Arthralgias]]

Revision as of 14:56, 25 October 2017


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

Overview

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

Differentiating Whipple's disease from other Diseases

Whipple's disease must be differentiated from other diseases that cause malabsorption, chronic diarrhea, joins involvement, and neurologic symptoms.

The following diseases have presentations similar to that of Whipple's disease.

The table below summarizes the findings that differentiate fatty causes of chronic diarrhea[1][2][3]

Cause History Physical exam Gold standard Treatment
lactose intolerance Lactose breath hydrogen test Restriction of lactose and maintain calcium and vitamin D intake.
Celiac sprue Immunoglobulin A (IgA) anti-tissue transglutaminase (TTG) antibody followed by upper endoscopy with biopsy. Dietary counseling, elimination of gluten in the diet.
Whipple disease Upper endoscopy with biopsies of the small intestine for T. whipplei testing (histology with PAS staining, polymerase chain reaction testing, and immunohistochemistry) Doxycycline and hydroxychloroquine are bactericidal

References

  1. Hertzler SR, Savaiano DA (1996). "Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance". Am J Clin Nutr. 64 (2): 232–6. PMID 8694025.
  2. Briet F, Pochart P, Marteau P, Flourie B, Arrigoni E, Rambaud JC (1997). "Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect?". Gut. 41 (5): 632–5. PMC 1891556. PMID 9414969.
  3. BLACK-SCHAFFER B (1949). "The tinctoral demonstration of a glycoprotein in Whipple's disease". Proc Soc Exp Biol Med. 72 (1): 225–7. PMID 15391722.

Template:WH Template:WS