Question

A 30-year-old man presents with a 1-year history of watery diarrhea. He has lost 5 kg. He has joint pains of 1-month duration. His stool examination for occult blood is negative. Stool culture is negative. No ova and cyst are seen in the stool. Laboratory tests fail to reveal rheumatoid factor or anti-nuclear antibodies. Serum calcium, phosphorous and alkaline phosphatase is 9.2 mg/dl, 4 mg/dl and 110 U/L respectively. A biopsy taken from the upper intestine shows distended macrophages in the lamina propria, which is found to be positive with PAS stain. What is the most likely diagnosis in this case?

1. Celiac sprue
2 Tropical sprue
3. Whipple disease
4. Disaccharidase deficiency
5. Amebic dysentery

Answer 1

The most likely diagnosis in this case is Whipple disease, a rare systemic infectious disease caused by the bacterium Tropheryma whipplei.

Step-by-step explanation:

The most likely diagnosis in this case is Whipple disease. Whipple disease is a rare systemic infectious disease caused by the bacterium Tropheryma whipplei. It primarily affects the small intestine but can also involve other organs. The symptoms of Whipple disease include chronic diarrhea, weight loss, joint pain, and malabsorption of nutrients.