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Tests and diagnosis
By Mayo Clinic staffThe process of diagnosing Whipple's disease typically includes the following tests:
- Physical exam. Your doctor will likely begin with a complete physical exam, looking for signs and symptoms that suggest the presence of this condition — for example, abdominal tenderness and skin darkening, particularly on sun-exposed parts of your body.
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Biopsy. An important step in diagnosing Whipple's disease is taking a tissue sample (biopsy), most often obtained from the lining of the small intestine. To do this, your doctor typically performs an upper endoscopy. The procedure uses a thin, flexible scope that passes through your mouth, throat, esophagus and stomach to your small intestine. The scope allows your doctor to view your digestive passages and obtain biopsies.
During the procedure, tissue samples are removed from several sites within your intestine. This tissue is microscopically examined for the presence of disease-causing bacteria and their lesions, and specifically for Tropheryma whipplei bacteria. If biopsies of the small intestine don't confirm the diagnosis, your doctor might biopsy an enlarged lymph node or perform other tests if you have neurological symptoms, such as seizures.
A DNA-based test known as polymerase chain reaction (PCR), which is available at some medical centers, can detect Tropheryma whipplei bacteria in biopsy specimens or spinal fluid samples.
- Blood tests. Your doctor may also order blood tests, such as a complete blood count (CBC). Blood tests can detect certain conditions associated with Whipple's disease, particularly anemia, which is a decline in the number of red blood cells, and low concentrations of albumin, a protein in your blood.
- Whipple's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/whipple/. Accessed April 20, 2010.
- Schneider T, et al. Whipple's disease: New aspects of pathogenesis and treatment. The Lancet. 2008;8:179.
- Infectious enterocolitis. In: Kumar V, et al. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/198838576-5/991412257/2060/201.html#4-u1.0-B978-1-4377-0792-2..50022-5--cesec139_1852. Accessed April 20, 2010.
- Apstein M, et al. Whipple's disease. http://www.uptodate.com/home/index.html. Accessed April 20, 2010.
- Marth T, et al. Whipple's disease. In: Mandell GL, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 76th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier: 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-443-06839-3..00101-6--s0025&uniq=198838576&isbn=978-0-443-06839-3&sid=991410994#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-0-443-06839-3..00101-6--s0030%3Bfrom%3Dtoc%3Btype%3DbookPage%3Bisbn%3D978-0-443-06839-3. Accessed April 30, 2010.
- Steckelberg JM (expert opinion). Mayo Clinic, Rochester, Minn. April 30, 2010.
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