A 23-year-old female has prolonged complaints diarrhea, flatus and pain in abdomen. Her appetite is preserved still she is experiencing weight loss. Physical examination is within normal limit. Small intestinal biopsy reveals- villous atrophy lymphocytic infiltration of lamina propria with crypt hyperplasia. She was put on a special diet and she improved. How can the above condition be differentiated from Whipple disease?

Clinical signs and symptoms with resolution of the same with (gluten free) diet, and HPE FINDINGS are suggestive of CELIAC disease. Whipple disease is due to infection with Trophyrema whipplei. Sign and symptoms are similar, but intestinal biopsy shows lipid vacuolation with infiltration of PAS positive macrophage with small bacilli whereas celiac disease show villous atrophy lymphocytic infiltration of lamina propria with crypt hyperplasia.