Whipple’s disease
DEFINITION
Whipple’s disease is a rare bacterial infection that most often affects your gastrointestinal system. Whipple’s disease interferes with normal digestion by impairing the breakdown of foods, such as fats and carbohydrates, and hampering your body’s ability to absorb nutrients.
Whipple’s disease also can infect other organs, including your brain, heart, joints and eyes.
Without proper treatment, Whipple’s disease can be serious or fatal. However, a course of antibiotics can treat Whipple’s disease.
CAUSES
The cause of Whipple’s disease is infection with the bacterium Tropheryma whipplei. This bacterium initially affects the mucosal lining of your small intestine, forming small lesions within the intestinal wall. The bacterium also damages the fine, hair-like projections (villi) that line the small intestine. With time, the infection can spread to other parts of your body.
Not much is known about the bacterium. Although it seems readily present in the environment, scientists don’t really know where it comes from or how it’s transmitted to humans. Not everyone who carries the bacterium develops the disease. Some researchers believe that people with the disease may have a genetic defect in their immune system response that makes them more susceptible to becoming ill when exposed to the bacterium.
Whipple’s disease is extremely uncommon.
SYMPTOMS
Common signs and symptoms
Gastrointestinal signs and symptoms are common in Whipple’s disease and may include:
- Diarrhea
- Abdominal cramping and pain, which may worsen after meals
- Weight loss, associated with the malabsorption of nutrients
Other frequent signs and symptoms associated with Whipple’s disease include:
- Inflamed joints, particularly your ankles, knees and wrists
- Fatigue
- Weakness
- Anemia
Less common signs and symptoms
In some cases, signs and symptoms of Whipple’s disease may include:
- Fever
- Cough
- Enlarged lymph nodes
- Skin darkening (hyperpigmentation) in areas exposed to the sun and in scars
- Chest pain
- Enlarged spleen
Neurological signs and symptoms may include:
- Difficulty walking
- Visual impairment, including lack of control of eye movements
- Seizures
- Confusion
- Memory loss
Symptoms tend to develop slowly over a period of many years in most people with this disease. In some cases, some symptoms, such as joint pain and weight loss, develop years before the gastrointestinal symptoms that lead to diagnosis.
When to see a doctor
Whipple’s disease is potentially life-threatening, yet usually treatable. Contact your doctor if you experience unusual signs or symptoms, such as unexplained weight loss or joint pain. Your doctor can perform tests to determine the cause of your symptoms.
Even after the infection is diagnosed and you’re receiving treatment, let your doctor know if your symptoms don’t improve. Sometimes antibiotic therapy isn’t effective because the bacteria are resistant to the particular drug you’re taking. The disease can recur, so it’s important to watch for the re-emergence of symptoms.
