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Malabsorption syndromes are commonly seen entities in USMLE exams. One of the most interesting of these is Whipple Disease. Boards would like to tease us with the strange combination of clinical features that we get in Whipple disease.

In addition to the classic findings of malabsorption such as greasy fatty stools, vitamin deficiencies, weight loss, ..etc, we find:

  • Arthralgias,
  • Neurologic symptoms in the form of cognitive changes and dementia,
  • Fever
  • Lymphadenopathy
  • and most interestingly Nystagmus and ophthalmoplegia
The latter is pathognomonically called Oculomasticatory myorhythmia which is jerking eye moved and involuntary contractions of the muscles of mastication at the same time!

Whipple disease is also discussed here
http://www.usmle-forums.com/usmle-step-1-forum/1275-diarrhea-weight-loss.html
 
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