Whipple's Disease and Tropical Sprue

by Carlo Raj, MD

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    00:01 Middle aged men, PCR analysis for bacterial DNA is confirmatory.

    00:06 Diarrhea, abdominal pain, arthritis, neurologic deficit, lymphadenopathy, remember this is a bacterial disease.

    00:14 Diagnosis here would include periodic acid schiff where you would find these granules in your macrophages and the management for this would be antibiotics such as cotrimoxazole.

    00:31 Tropical Sprue, as the name implies, these would be tropical regions, associated with megaloblastic anemia.

    00:38 Tropical Sprue, some would say that it is infectious but exact cause and etiology is pretty much unknown, but then the reason for the folic deficiency resulting in megablastic anemia, that´s the part they were unclear about.

    00:51 So the most important symptom is something that pretty much remains a mystery or idiopathic.

    00:57 Here, the pathology similar to Celiac Sprue, but has nothing to do with gluten.

    01:05 So you have three conditions here in which you wanna keep in mind when you´re dealing with Celiac just to make sure.

    01:10 Celiac disease, we know everything about.

    01:13 Next, we take a look at Whipple but that´s your Tropheryma, that´s your bacteria periodic acid schiff. Yes, diarrhea there as well.

    01:21 Tropical Sprue, here once again, it seems as though that it destroys the intestine, megaloblastic anemia, unknown cause maybe perhaps infectious because of this, tetracycline antibiotic but more importantly, the folate.

    01:36 Not the B12 deficiency here that you find in Tropical Sprue.

    About the Lecture

    The lecture Whipple's Disease and Tropical Sprue by Carlo Raj, MD is from the course Small and Large Intestine Diseases: Basic Principles with Carlo Raj.

    Included Quiz Questions

    1. PAS-positive granules in small bowel biopsy
    2. Complete atrophy of villi in small bowel biopsy
    3. Partial atrophy of villi in small bowel biopsy
    4. Transmural inflammation with crypt abscess
    5. Damaged crypts and microgranulomas
    1. Gram-positive bacilli
    2. Gram-negative bacilli
    3. Gram-positive cocci
    4. Gram-negative cocci
    5. Acid-fast bacilli
    1. Folate-deficiency anemia
    2. Iron-deficiency anemia
    3. Anemia of chronic disease
    4. Hemolytic anemia
    5. Sideroblastic anemia
    1. PCR analysis for bacterial DNA
    2. Biopsy of the intestine
    3. Colonoscopy
    4. Stool culture
    5. Western blot for bacterial proteins
    1. Urethritis
    2. Lymphadenopathy
    3. Arthritis
    4. Abdominal pain
    5. Neurological deficits

    Author of lecture Whipple's Disease and Tropical Sprue

     Carlo Raj, MD

    Carlo Raj, MD

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