WHIPPLE'S DISEASE: A REVIEW OF THE CHALLENGES IN EARLY DIAGNOSIS

Abstract

Whipple's disease is a rare infectious disease caused by Tropheryma whipplei, whose early diagnosis remains a significant clinical challenge due to the wide variability of manifestations and the lack of specificity of initial symptoms. This narrative review aimed to critically analyze the main obstacles to the initial recognition of the disease, integrating evidence related to clinical, histopathological, and molecular aspects. The literature demonstrates that diagnostic delay is frequently associated with similarity to other gastrointestinal, rheumatological, and neurological conditions, in addition to the limitations inherent in traditional methods, such as duodenal biopsy with PAS staining. Molecular techniques, especially PCR for the detection of T. whipplei, emerge as valuable tools, although they are still poorly standardized and of limited availability. The findings reinforce the need for greater awareness among healthcare professionals, standardization of diagnostic protocols, and expansion of access to complementary methods in order to reduce underdiagnosis and improve patient prognosis.