Neurologic Manifestations of Whipple Disease Differential Diagnoses

  • Author: George C Bobustuc, MD; Chief Editor: Karen L Roos, MD   more...
 
Updated: Feb 6, 2012
 
 

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

George C Bobustuc, MD  Consulting Staff, Department of Neuro-oncology, MD Anderson Cancer Center of Orlando

George C Bobustuc, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, Society for Neuro-Oncology, and Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Norman C Reynolds Jr, MD  Neurologist, Veterans Affairs Medical Center of Milwaukee; Clinical Professor, Medical College of Wisconsin

Norman C Reynolds Jr, MD is a member of the following medical societies: American Academy of Neurology, Association of Military Surgeons of the US, Movement Disorders Society, Sigma Xi, and Society for Neuroscience

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Florian P Thomas, MD, MA, PhD, Drmed  Director, Regional MS Center of Excellence, St Louis Veterans Affairs Medical Center; Director, National MS Society Multiple Sclerosis Center; Director, Neuropathy Association Center of Excellence, Professor, Department of Neurology and Psychiatry, Associate Professor, Institute for Molecular Virology, St Louis University School of Medicine

Florian P Thomas, MD, MA, PhD, Drmed is a member of the following medical societies: American Academy of Neurology, American Neurological Association, American Paraplegia Society, Consortium of Multiple Sclerosis Centers, and National Multiple Sclerosis Society

Disclosure: Nothing to disclose.

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Chief Editor

Karen L Roos, MD  John and Nancy Nelson Professor of Neurology, Professor of Neurological Surgery, Department of Neurology, Indiana University School of Medicine

Karen L Roos, MD is a member of the following medical societies: American Academy of Neurology and American Neurological Association

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Mark Gilbert, MD to the development and writing of this article.

References

  1. Whipple GH. A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues. Johns Hopkins Hosp Bull. 1907;18:382-391.

  2. Black-Schaffer B. The tinctorial demonstration of a glycoprotein in Whipple's disease. Proc Soc Exp Biol Med. 1949;72:225.

  3. Paulley JW. A case of Whipple's disease (intestinal lipodystrophy). Gastroenterology. 1952;22:128-33.

  4. Keinath RD, Merrell DE, Vlietstra R, Dobbins WO 3rd. Antibiotic treatment and relapse in Whipple's disease. Long-term follow-up of 88 patients. Gastroenterology. Jun 1985;88(6):1867-73. [Medline].

  5. Wilson KH, Blitchington R, Frothingham R, Wilson JA. Phylogeny of the Whipple's-disease-associated bacterium. Lancet. Aug 24 1991;338(8765):474-5. [Medline].

  6. Relman DA, Schmidt TM, MacDermott RP, Falkow S. Identification of the uncultured bacillus of Whipple's disease. N Engl J Med. Jul 30 1992;327(5):293-301. [Medline].

  7. Ramzan NN, Loftus E, Burgart LJ, et al. Diagnosis and monitoring of Whipple disease by polymerase chain reaction. Ann Intern Med. Apr 1 1997;126(7):520-7. [Medline].

  8. Raoult D, Birg ML, La Scola B, Fournier PE, Enea M, Lepidi H, et al. Cultivation of the bacillus of Whipple's disease. N Engl J Med. Mar 2 2000;342(9):620-5. [Medline].

  9. Raoult D, Ogata H, Audic S. Tropheryma whipplei Twist: a human pathogenic Actinobacteria with a reduced genome. Genome Res. Aug 2003;13(8):1800-9. [Medline].

  10. Raoult D, Ogata H, Audic S, et al. Tropheryma whipplei Twist: a human pathogenic Actinobacteria with a reduced genome. Genome Res. Aug 2003;13(8):1800-9. [Medline].

  11. Bentley SD, Maiwald M, Murphy LD, Pallen MJ, Yeats CA, Dover LG, et al. Sequencing and analysis of the genome of the Whipple's disease bacterium Tropheryma whipplei. Lancet. Feb 22 2003;361(9358):637-44. [Medline].

  12. Dorman SE, Holland SM. Interferon-gamma and interleukin-12 pathway defects and human disease. Cytokine Growth Factor Rev. Dec 2000;11(4):321-33. [Medline].

  13. Fenollar F, Laouira S, Lepidi H, Rolain JM, Raoult D. Value of Tropheryma whipplei quantitative polymerase chain reaction assay for the diagnosis of Whipple disease: usefulness of saliva and stool specimens for first-line screening. Clin Infect Dis. Sep 1 2008;47(5):659-67. [Medline].

  14. Bonhomme CJ, Renesto P, Nandi S, Lynn AM, Raoult D. Serological microarray for a paradoxical diagnostic of Whipple's disease. Eur J Clin Microbiol Infect Dis. Oct 2008;27(10):959-68. [Medline].

  15. Panegyres PK, Foster JK, Fallon M, Connor C. The amnesic syndrome of primary Whipple disease of the brain. Cogn Behav Neurol. Mar 2010;23(1):49-51. [Medline].

  16. Schwartz MA, Selhorst JB, Ochs AL, Beck RW, Campbell WW, Harris JK, et al. Oculomasticatory myorhythmia: a unique movement disorder occurring in Whipple's disease. Ann Neurol. Dec 1986;20(6):677-83. [Medline].

  17. Brandle M, Ammann P, Spinas GA, Dutly F, Galeazzi RL, Schmid C, et al. Relapsing Whipple's disease presenting with hypopituitarism. Clin Endocrinol (Oxf). Mar 1999;50(3):399-403. [Medline].

  18. von Herbay A, Ditton HJ, Schuhmacher F, Maiwald M. Whipple's disease: staging and monitoring by cytology and polymerase chain reaction analysis of cerebrospinal fluid. Gastroenterology. Aug 1997;113(2):434-41. [Medline].

  19. De Coene B, Gilliard C, Indekeu P, Duprez T, Trigaux JP. Whipple's disease confined to the central nervous system. Neuroradiology. May 1996;38(4):325-7. [Medline].

  20. Le Scanff J, Gaultier JB, Durand DV, Durieu I, Celard M, Benito Y, et al. [Tropheryma whipplei and Whipple disease: false positive PCR detections of Tropheryma whipplei in diagnostic samples are rare]. Rev Med Interne. Nov 2008;29(11):861-7. [Medline].

  21. Seneca V, Imperato A, Colella G, Cioffi V, Mariniello G, Gangemi M. Recurrent acute obstructive hydrocephalus as clinical onset of cerebral Whipple's disease. Clin Neurol Neurosurg. Oct 2010;112(8):717-21. [Medline].

  22. Adams M, Rhyner PA, Day J, DeArmond S, Smuckler EA. Whipple's disease confined to the central nervous system. Ann Neurol. Jan 1987;21(1):104-8. [Medline].

  23. Benito-León J, Sedano LF, Louis ED. Isolated central nervous system Whipple's disease causing reversible frontotemporal-like dementia. Clin Neurol Neurosurg. Jul 2008;110(7):747-9. [Medline].

  24. Clarke CE, Falope ZF, Abdelhadi HA, Franks AJ. Cervical myelopathy caused by Whipple's disease. Neurology. May 1998;50(5):1505-6. [Medline].

  25. Comer GM, Brandt LJ, Abissi CJ. Whipple's disease: a review. Am J Gastroenterol. Feb 1983;78(2):107-14. [Medline].

  26. Cooper GS, Blades EW, Remler BF, Salata RA, Bennert KW, Jacobs GH. Central nervous system Whipple's disease: relapse during therapy with trimethoprim-sulfamethoxazole and remission with cefixime. Gastroenterology. Mar 1994;106(3):782-6. [Medline].

  27. Dobbins WO 3rd. The diagnosis of Whipple's disease. N Engl J Med. Feb 9 1995;332(6):390-2. [Medline].

  28. Fenollar F, Birg ML, Gauduchon V. Culture of Tropheryma whipplei from human samples: a 3-year experience (1999 to 2002). J Clin Microbiol. Aug 2003;41(8):3816-22. [Medline].

  29. Fenollar F, Fournier PE, Robert C. Use of genome selected repeated sequences increases the sensitivity of PCR detection of Tropheryma whipplei. J Clin Microbiol. Jan 2004;42(1):401-3. [Medline].

  30. Knox DL, Green WR, Troncoso JC, Yardley JH, Hsu J, Zee DS. Cerebral ocular Whipple's disease: a 62-year odyssey from death to diagnosis. Neurology. Apr 1995;45(4):617-25. [Medline].

  31. Kowalczewska M, Villard C, Lafitte D, Fenollar F, Raoult D. Global proteomic pattern of Tropheryma whipplei: a Whipple's disease bacterium. Proteomics. Mar 2009;9(6):1593-616. [Medline].

  32. Louis ED, Lynch T, Kaufmann P, Fahn S, Odel J. Diagnostic guidelines in central nervous system Whipple's disease. Ann Neurol. Oct 1996;40(4):561-8. [Medline].

  33. Lynch T, Odel J, Fredericks DN, Louis ED, Forman S, Rotterdam H, et al. Polymerase chain reaction-based detection of Tropheryma whippelii in central nervous system Whipple's disease. Ann Neurol. Jul 1997;42(1):120-4. [Medline].

  34. Marth T, Neurath M, Cuccherini BA, Strober W. Defects of monocyte interleukin 12 production and humoral immunity in Whipple's disease. Gastroenterology. Aug 1997;113(2):442-8. [Medline].

  35. Marth T, Roux M, von Herbay A, Meuer SC, Feurle GE. Persistent reduction of complement receptor 3 alpha-chain expressing mononuclear blood cells and transient inhibitory serum factors in Whipple's disease. Clin Immunol Immunopathol. Aug 1994;72(2):217-26. [Medline].

  36. Masselot F, Boulos A, Maurin M. Molecular evaluation of antibiotic susceptibility: Tropheryma whipplei paradigm. Antimicrob Agents Chemother. May 2003;47(5):1658-64. [Medline].

  37. Moos V, Kunkel D, Marth T, Feurle GE, LaScola B, Ignatius R, et al. Reduced peripheral and mucosal Tropheryma whipplei-specific Th1 response in patients with Whipple's disease. J Immunol. Aug 1 2006;177(3):2015-22. [Medline].

  38. Pollock S, Lewis PD, Kendall B. Whipple's disease confined to the nervous system. J Neurol Neurosurg Psychiatry. Dec 1981;44(12):1104-9. [Medline].

  39. Richardson DC, Burrows LL, Korithoski B, Salit IE, Butany J, David TE, et al. Tropheryma whippelii as a cause of afebrile culture-negative endocarditis: the evolving spectrum of Whipple's disease. J Infect. Aug 2003;47(2):170-3. [Medline].

  40. Ryser RJ, Locksley RM, Eng SC, Dobbins WO 3rd, Schoenknecht FD, Rubin CE. Reversal of dementia associated with Whipple's disease by trimethoprim-sulfamethoxazole, drugs that penetrate the blood-brain barrier. Gastroenterology. Apr 1984;86(4):745-52. [Medline].

  41. Sanavro SM, Voerman HJ. Whipple's disease: easily diagnosed, if considered. Neth J Med. Mar 2009;67(3):108. [Medline].

  42. Schneider T, Stallmach A, von Herbay A. Treatment of refractory Whipple disease with interferon-gamma. Ann Intern Med. Dec 1 1998;129(11):875-7. [Medline].

  43. Schnider P, Trattnig S, Kollegger H, et al. MR of cerebral Whipple disease. AJNR Am J Neuroradiol. Jun-Jul 1995;16(6):1328-9. [Medline].

  44. Sloan LM, Rosenblatt JE, Cockerill FR. Detection of Tropheryma whipplei DNA in clinical specimens by LightCycler real-time PCR. J Clin Microbiol. Jul 2005;43(7):3516-8. [Medline].

  45. Swartz MN. Whipple's disease--past, present, and future. N Engl J Med. Mar 2 2000;342(9):648-50. [Medline].

  46. Wilson KH. New vistas for bacteriologists: analysis based on 16S rRNA sequences provides a rapid and reliable approach to the identity of human pathogens. ASM News. 1992;58:318-21.

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.