RT Book, Section A1 Cunnane, Gaye A2 Stone, John H. SR Print(0) ID 1180198449 T1 Whipple Disease T2 Current Diagnosis & Treatment: Rheumatology, 4e YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781259644641 LK accessmedicine.mhmedical.com/content.aspx?aid=1180198449 RD 2024/03/28 AB Rare disease (1 in 1,000,000) caused by Tropheryma whipplei (TW).Mainly presents in middle-aged/older males.Large joint arthritis is the most common manifestation and precedes the development of systemic symptoms by many years.The four cardinal signs are arthritis, weight loss, abdominal pain, and diarrhea.Oculomasticatory myorhythmia (OMM) is a pathognomonic but late manifestation.Diagnosis is made by demonstration of characteristic periodic acid–Schiff (PAS)-positive intracellular inclusions and identification of TW by polymerase chain reaction (PCR) of involved tissues or fluids.All patients with confirmed Whipple disease should have PCR for TW tested on cerebrospinal fluid (CSF), even those without neurological symptoms.Prolonged antibiotic treatment is required (>1 year).