Overview
Whipple's disease is a rare bacterial infection that primarily affects the joints and digestive system. The bacteria, called Tropheryma whipplei, impair the breakdown of food and the body's ability to absorb nutrients. The disease can also infect other organs, such as the brain, heart, and eyes. Common symptoms include diarrhea, stomach cramping and pain, weight loss, and inflamed joints. Whipple's disease can be serious or fatal if left untreated, but antibiotics can effectively treat it. The exact causes and risk factors are not well understood, but the disease is extremely rare, affecting fewer than 1 in 1 million people.
Understanding the disease
Symptoms
The symptoms of Whipple's disease include diarrhea, stomach cramping and pain, weight loss, joint pain, fatigue, weakness, anemia, and inflammation of the joints, particularly in the ankles, knees, and wrists. Other less common symptoms may include fever, cough, enlarged lymph nodes, skin darkening in sun-exposed areas and scars, difficulty walking, vision problems, confusion, and memory loss. If you experience any of these symptoms, it is important to contact your doctor for proper diagnosis and treatment.
Risk Factors
The risk factors for developing Whipple disease are not clearly identified due to limited knowledge about the bacteria that cause the disease. However, based on available reports, it appears more likely to affect individuals with a genetic defect in their immune system response that makes them more susceptible to the bacteria. Whipple disease is extremely rare, affecting fewer than 1 in 1 million people.
Development
Whipple disease is caused by a type of bacterium called Tropheryma whipplei. The bacteria affect the mucosal lining of your small intestine first, forming small sores (lesions) within the wall of the intestine. The bacteria also damage the fine, hairlike projections (villi) that line the small intestine. Symptoms tend to develop slowly over many years in most people with this disease, and they may include joint pain, weight loss, diarrhea, stomach cramping and pain, and malabsorption of nutrients. In some cases, the infection may spread to other organs, such as the brain, heart, and eyes, leading to various complications. Whipple disease can be potentially life-threatening yet usually treatable with antibiotics.
Assessment and Diagnosis
Diagnosis
To diagnose Whipple's disease, the process typically includes a physical exam, blood tests, and a biopsy. During the physical exam, the doctor looks for signs and symptoms such as stomach tenderness and skin darkening. Blood tests can detect anemia and low albumin levels. A biopsy, usually taken during an upper endoscopy, involves taking tissue samples from the small intestine to check for the presence of the disease-causing bacteria and lesions. In some cases, other tests such as a DNA-based test or imaging tests may be requested to confirm the diagnosis or rule out other conditions.
Management and Treatment
Complications
Potential complications of Whipple disease include nutritional deficiencies, which can lead to fatigue, weakness, weight loss, and joint pain. The disease can also spread to other organs, including the brain, heart, and eyes, potentially causing irreversible damage. Late diagnosis and delayed treatment can contribute to the progression of the disease and increase the risk of associated deaths. Other rare complications may include fever, cough, enlarged lymph nodes, skin darkening, chest pain, difficulty walking, vision problems, confusion, and memory loss. It's essential to contact a doctor if you experience any unusual signs or symptoms, such as unexplained weight loss or joint pain, as Whipple disease is potentially life-threatening yet usually treatable with antibiotics.
Treatment
Whipple's disease is typically treated with antibiotics, such as penicillin or tetracycline. The most common antibiotic used to treat Whipple's disease is penicillin, which is effective against the bacteria that cause the infection. A course of antibiotics can be effective in treating Whipple's disease, and it is usually curable with appropriate treatment. However, if left untreated, Whipple's disease can be serious or even fatal.