A 50-year-old male patient presented to the OPD with non-destructive migratory ahritis involving left lower limb joints along with intermittent episodes of fever and myalgias. Patient also complained of multiple episodes of diarrhea along with abdominal pain and significant weight loss. O/E, Cervical lymphadenopathy Hepatosplenomegaly Skin hyperpigmentation Mild anterior uveitis Lab finding revealed negative RA factor and ANA Ab tests, anemia and hypereosinophilia. Endoscopy was done and it revealed pale, yellow, shaggy mucosa with erythema and ulceration past the 1st pa of duodenum. Biopsy from the small intestine was taken and PAS staining was done. PCR was ordered to diagnose the above condition. Which RNA sequencing is used to diagnose the above condition: –
A 50-year-old male patient presented to the OPD with non-destructive migratory ahritis involving left lower limb joints along with intermittent episodes of fever and myalgias. Patient also complained of multiple episodes of diarrhea along with abdominal pain and significant weight loss. O/E, Cervical lymphadenopathy Hepatosplenomegaly Skin hyperpigmentation Mild anterior uveitis Lab finding revealed negative RA factor and ANA Ab tests, anemia and hypereosinophilia. Endoscopy was done and it revealed pale, yellow, shaggy mucosa with erythema and ulceration past the 1st pa of duodenum. Biopsy from the small intestine was taken and PAS staining was done. PCR was ordered to diagnose the above condition. Which RNA sequencing is used to diagnose the above condition: –
💡 Explanation
**Core Concept**
The underlying condition being tested involves a complex interplay of gastrointestinal, rheumatologic, and hematologic symptoms, suggesting a systemic disease with multi-organ involvement. The presence of migratory arthritis, fever, myalgias, diarrhea, abdominal pain, weight loss, cervical lymphadenopathy, hepatosplenomegaly, skin hyperpigmentation, and mild anterior uveitis points towards a condition that affects various body systems. The use of **PAS staining** and **PCR** for diagnosis hints at an infectious or parasitic etiology.
**Why the Correct Answer is Right**
Given the combination of symptoms such as diarrhea, abdominal pain, significant weight loss, and the endoscopic findings of pale, yellow, shaggy mucosa with erythema and ulceration past the first part of the duodenum, along with the results of **PAS staining** and the need for **PCR** for diagnosis, the condition strongly suggests **Whipple's disease**. This rare, systemic bacterial infection caused by **Tropheryma whipplei** leads to malabsorption, weight loss, and migratory arthritis, among other symptoms. The diagnosis of Whipple's disease often involves **PCR** to detect the bacterial DNA in tissues.
**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect because it does not relate to the diagnosis of Whipple's disease or similar conditions characterized by the described symptoms.
**Option B:** Incorrect as it is not associated with the diagnosis of the condition suggested by the clinical presentation and laboratory findings.
**Option C:** Incorrect because, although it might be related to certain infectious diseases, it is not specifically used for diagnosing Whipple's disease.
**Option D:** Incorrect as it does not pertain to the diagnosis of the condition described.
**Clinical Pearl / High-Yield Fact**
Whipple's disease is a classic example of a systemic infection that can present with a wide range of symptoms, including gastrointestinal, musculoskeletal, and ocular manifestations. The diagnosis is often delayed due to its rarity and non-specific initial presentation, highlighting the importance of considering Whipple's disease in patients with unexplained, multi-system symptoms.
**Correct Answer:** D. 16S rRNA sequencing
✓ Correct Answer: A. 16S rRNA
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram