Whipple's Disease
Whipple’s disease is a rare bacterial
infection of the small intestine that causes
malabsorption of nutrients. In this disease, lesions develop in
the lining of the small intestine and villi or
finger-like projections that help absorb nutrients are destroyed.
Whipple’s disease is caused by the bacteria Tropheryma
whippelli.
Symptoms
The symptoms of Whipple’s disease are:
- Chronic diarrhea
- Bloating
- Cramps
- Pain in the abdomen
- Flatulence
- Loss of appetite
- Weight loss and malnutrition
- Fatigue
- Steatorrhea or foul-smelling stool
- Anemia, or reduced red blood cell count
Because the bacterial infection can spread and affect other organs
such as the heart, lungs, joints, eyes, and brain, the patient
may also experience the following symptoms:
- Painful and inflamed joints, and arthritis
- Fever
- Chronic cough
- Chest pain, due to accumulation of fluids in the lungs
- Heart murmur
- Darkened skin color
If the infection spreads to the brain, the following neurological
symptoms may appear:
- Personality changes
- Headaches
- Confusion
- Forgetfulness
- Uncontrollable eye movements or vision disturbances
- Numbness
- Tingling sensations in the hands and feet
- Seizures
Because Whipple’s disease leads to a decrease in the body’s
ability to absorb nutrients, the following symptoms of vitamin
deficiencies may be present:
- Scaling of the skin or hyperkeratosis, caused by the deficiency
of vitamin A
- Muscle spasm and bone pain, caused by deficiency of vitamin
D and calcium
- Bruising and blood in urine, caused by deficiency of vitamin
K
How is Whipple's Disease Diagnosed?
Your doctor would perform the following tests to diagnose Whipple’s
disease:
- Endoscopy
A flexible tube with camera and lights attached called an endoscope
is used to visualize whitish-looking and damaged villi in the
small intestine. A biopsy or tissue sample is taken at this
point to confirm the diagnosis.
- Physical exam
Enlargement of the lymph nodes, liver and spleen, fever, abdominal
tenderness, fluid in the belly and chest, as well as swollen
feet are signs of Whipple’s disease that has spread to
other organs in the body.
- Stool sample
Excess fat is a hallmark of malabsorption diseases, including
Whipple’s disease.
- Blood test
Anemia and deficiencies in vitamins can be readily confirmed
by a blood test.
Treatment for Whipple’s Disease
Whipple’s disease is usually treated with:
- Antibiotics, such as tetracycline, penicillin,
as well as sulfa drugs.
- Fluid and Electrolytes replacements
- Vitamin and nutritional supplements
Folic acid, iron, calcium and various vitamin supplements may
also be given.
Prognosis
Treatments usually result in alleviation of the symptoms within
1 to 3 months. However, recurrence of the disease even after a
successful treatment is common.
Left untreated, Whipple’s disease can be fatal.
