Aids in the diagnosis of Whipple disease, especially for identifying inconclusive or suspicious cases

• Container/tube:
  • Preferred: Lavender top (EDTA)
  • Acceptable: Navy (EDTA), sterile vial containing EDTA-derived aliquot, red clot tube (no anticoagulant), or sterile container

1. Place a minimum of 0.5 mL of fluid into a Lavender (EDTA) tube 
2. Mix by gentle inversion
3. Send specimen in original tube (preferred)

Lavender (EDTA), 4mL

Fresh tissue or biopsy

• Sources: Small intestine tissue (duodenum, ileum, or jejunum), lymph node, other visceral tissue, synovial tissue, gastrointestinal tissue, heart valve, or brain
• Specimen volume: Entire collection or 5 mm³
  

1. Collect fresh tissue specimen
2. Submit tissue only, do not add fluid to tissue

Fluid

• Sources: Cerebrospinal or ocular (eg, vitreous humor)
• Specimen volume: 0.5 mL

Sterile vial/container

Refrigerated (preferred): <7 days

Frozen: <7 days

• Slides
• Bone marrow
• PCR testing cannot be added on to a sample that has been opened and/or used for other testing. If the sample has already been used for testing, a new specimen will need to be collected.

Real-time Polymerase Chain Reaction (PCR)

• A positive result indicates the presence of Tropheryma whipplei DNA.
• A negative result indicates the absence of detectable T whipplei DNA, but does not negate the presence of the organism and may occur due to inhibition of PCR, sequence variability underlying primers or probes, or the presence of T whipplei DNA in quantities less than the limit of detection of the assay.