WHIPPLES DISEASE

1 it is chronic multisystem disease associated with malabsorbtion
2 it is caused by gram positive bacteria   - Tropheryma whippelii
3 there is characteristic PAS positive macrophages in the small intestine causing malabsorbtion

## clinical features

1 symptoms are steatorrhoea , polyarthritis , weight  loss and abdominal pain
2 other features are migratory arthralgias ,fever,ophthalmological features and nurological fea. Including dementia in late stager
3 signs include generalised l n pathy ,Arthopathy ,skin pigmentation ,abdominal disten. And tenderness

## investigations

jejunal biopsy and biopsy of other tissue shows plenty of PAS positive macrophages which contain small bacilli

## treatment

trimethoprin-sulpmethoxazole (double strength) twice a day for 1 year