 Whipple’s disease
Definition Alternative Names Causes, incidence, and risk factors Symptoms Signs and tests Treatment Support Groups Complications Calling your health care provider References DefinitionWhipple's disease is a rare condition that prevents the small intestines from properly absorbing nutrients. This is called malabsorption. Alternative NamesIntestinal lipodystrophy Causes, incidence, and risk factorsWhipple's disease is caused by infection from bacteria called Tropheryma whippelii. The disorder mainly affects middle-aged white men. Whipple's disease is extremely rare. Risk factors are unknown. SymptomsSymptoms usually start slowly. Joint paint is the most common initial symptom. After that, often several years later, symptoms of gastrointestinal (GI) infection develop. Other symptoms may include: Signs and testsPossible signs: Tests to diagnose Whipple's disease may include: - Complete blood count (CBC)
- Polymerase chain reaction (PCR) testing of the affected tissue for Tropheryma whippelii
- Small bowel biopsy
- Upper GI endoscopy (viewing the intestines with a flexible, lighted tube in a process called enteroscopy )
This disease may also change the results of the following tests: TreatmentPeople with Whipple's disease need to take long-term antibiotics to cure any infections of the brain and central nervous system. An antibiotic called ceftriaxone is given through a vein (IV). It is followed by another antibiotic (such as trimethoprim-sulfamethoxazole) taken by mouth for up to 1 year. If symptoms come back during antibiotic use, the antibiotic treatment may be changed. Your health care provider should closely follow your progress, because signs of the disease can return after you finish therapy. Those who have nutritional deficiencies from malabsorption will also need to take dietary supplements. Support GroupsWithout treatment, the condition is usually fatal. Treatment relieves symptoms and can cure the disease. Complications- Brain damage
- Heart valve damage (from endocarditis)
- Nutritional deficiencies
- Symptoms return (which may be because of drug resistance)
- Weight loss
Calling your health care providerCall your health care provider if you have persistent joint pain, abdominal pain, or diarrhea. If you are being treated for Whipple's disease, call your health care provider if: - Symptoms worsen or do not improve
- Symptoms reappear
- New symptoms develop
ReferencesWest SG. Systemic diseases in which arthritis is a feature. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 297. Physician ReferenceInternational Classification of Diseases, 9th Revision (ICD9)040.2
Review Date: 5/4/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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