TABLE 5.

Comparision of histopathology (PAS-positive inclusions in macrophages) and PCR^a for patients with suspected or proven Whipple's disease

Clinical manifestations	Type of specimen	Result by		Reference(s)
		PAS staining	PCR amplification
Spondylodiscitis, occasional fever, no diarrhea	Terminal ileum	+	+	5
	Duodenum	−	+
	Colon	−	+
	Lumbar spine	−	+
Blurred vision, parkinsonian syndrome	Small bowel	−	+	8
Neck pain and limb paraesthesia	Cord biopsy	+	NDb	30
	Jejunal biopsy	−	+
Oculomotoric disorders, nystagmus, fever, weight loss	Cerebrospinal fluid	−	+	31, 36
Suspected neurological Whipple's disease	Intestine	+	−	36
Weight loss, abdominal lymphadenopathy, fever, arthritis	Duodenum	−c	ND	67
	Joint fluid	ND	+
Endocarditis	Aortic valve	+	+	79
	Duodenum	−	+
Relapsing oligoarthritis	Duodenum	−	+	83
Arthralgias, chronic colitis	Duodenum	−	+	83
	Ileum	+	ND
Arthritis	Joint fluid	−	+	83
Gaze, cognitive changes, depression	Duodenum	−	+	107
Hepatosplenomegaly, episodic fever, granulomatous lymphadenopathy, no gastroinestinal symptoms	Lymph nodes	+	ND	129
	Duodenum	−	+
	Spleen	+	+
	Blood	ND	+
Arthropathy, episodic fever, hepatosplenomegaly, granulomatous lymphadenopathy, episodes of intestinal obstruction	Synovium	−	ND	129
	Duodenum	−	+
	Blood	ND	+
Fever, night sweats, para-aortic lymphadenopathy, no gastrointestinal symptoms	Lymph nodes	+	−	129
	Duodenum	−	+
	Blood	ND	+
Spastic tetraparesis, no gastrointestinal symptoms	Spinal cord	+	ND	129
	Duodenum	−	+
Anorexia, arthritis, night sweats, lymphadenopathy	Duodenum	+	+	133
	Antrum	−	+
	Blood	ND	+
Fever, neurological symptoms, hyperpigmentation	Mesenteric lymph node	+	ND	133
	Duodenum	−	+
Weight loss, diarrhea, cachexia	Duodenum	+	+	133
	Antrum	+	+
	Stomach	−	+
	Blood	ND	+
Weight loss, diarrhea, arthralgias, increased skin pigmentation	Duodenum	+	+	143
	Stomach	−	+
	Liver	−	+
Osteoporosis, anemia, poor appetite, occasional diarrhea, steatorrhea (diagnosed as sprue)	Small bowel	?d	+	150
Prolonged episodic diarrhea (diagnosed as sprue)	Small bowel	−	+	150
Fever, enlarged paraortic lymph nodes	Small bowel	−	+	150
	Lymph nodes	?	+
Diarrhea, weight loss	Small bowel	−	+	150
Bilateral uveitis, arthritis, weight loss	Vitreous fluid	+	+	155
	Duodenum	−	+

^aDifferent PCR methods were used. 

^bND, not done. 

^cPositive by electron microscopy. 

^d?, suspicious histologic findings.