Definition

Whipple's disease is a rare bacterial infection that interferes with normal digestion by preventing the small intestines from letting nutrients pass into the rest of the body to be absorbed (malabsorption).

Whipple’s disease can also infect other organs, including the brain, heart, joints and eyes. Left untreated, the condition can be lead to serious complications as well as possible death. However, a course of antibiotic treatment can help cure Whipple's disease.

 

Symptoms

Symptoms of Whipple’s disease tend to develop slowly. Joint pain is the most common early symptom.

Gastrointestinal signs and symptoms are common in Whipple's disease and may include:

  • Diarrhea
  • Stomach cramps
  • Stomach pain
  • Weight loss

 

Other frequent signs and symptoms associated with Whipple's disease include:

  • Joint pain in the ankles, knees and wrists
  • Tiredness
  • Muscle weakness
  • Low red blood cell count (Anemia)

 

Less common signs and symptoms of Whipple’s disease may include:

  • Temperature
  • Chronic cough
  • Enlarged lymph nodes
  • Pain in the chest
  • Dark coloration of the skin
  • Enlarged spleen

Neurological signs and symptoms may include:

  • Difficulty walking
  • Vision impairment
  • Seizures
  • Mental changes
  • Memory loss

 

Causes

Whipple's disease is caused by infection with the bacterium Tropheryma whipplei. The bacterium affects the normal digestion of the small intestine by impairing the breakdown of foods, such a fats and carbohydrates, and preventing the body from absorbing nutrients. With time, the infection can spread to other areas of the body.

Whipple’s disease is extremely uncommon and researchers don’t really know where it comes from or how it spreads. Some believe that individuals with the disease may have a genetic defect in their immune system, making them more prone to becoming sick when exposed to the bacterium.

 

Risk factors

Factors that can increase the risk of Whipple’s disease are not well known since so little is known about the bacterium that causes the disease in the first place. Based on some research findings, it appears more likely to affect:

  • Men
  • Individuals among the ages of 40 and 60
  • Individuals of Caucasian race in North America and Europe

 

Complications

Possible complications that can arise from Whipple’s disease include the following:

  • Damage to the villi, hair like projections that help the body absorb nutrients
  • Brain damage
  • Heart valve damage
  • Possible death

Treatment

Treatment options for Whipple's disease typically involve antibiotic treatment to help destroy the bacteria that causing the infection. Symptoms should improve within one to two weeks of starting antibiotic treatment and go away completely within about one month.

Treatment for standard cases involves:

  • An antibiotic called ceftriaxone  given through a vein (IV) followed by an antibiotic called sulfamethoxazole-trimethoprim, for one to two years.

Possible side effects: sickness, vomiting and diarrhea

Treatment for severe cases involves:

  • An antibiotic called doxycycline (Vibramycin) combined with the antimalarial drug hydroxychloroquine (Plaquenil), for 12 to 18 months.

Possible side effects: Loss of appetite, sickness, vomiting, and stomach cramps, headache, diarrhea and dizziness.

Due to the prolonged use of antibiotics, a doctor may recommend regular checkups to monitor the condition for development of resistance to the drugs as well as the use of vitamin and mineral supplements to ensure proper nutritional support.