Health Encyclopedia

Whipple’s disease

Definition

Whipple's disease is a rare condition in which infection makes the intestine unable to properly absorb nutrients. This is called malabsorption.

Alternative Names

Intestinal lipodystrophy

Causes, incidence, and risk factors

Whipple's disease is most likely caused by infection with Tropheryma whippelii. The disorder primarily affects middle-aged white men, and the onset of symptoms is usually slow. Without treatment, it may be fatal.

Whipple's disease is extremely rare, and risk factors are unknown.

Symptoms

Abdominal pain
Fatty stools
Fever
Diarrhea
Weight loss
Gastrointestinal bleeding
Enlarged lymph glands
Joint pain
Edema
Gray to brown skin coloration
Mental status changes
Memory loss

Signs and tests

Primary tests:

Small bowel biopsy showing infection-fighting cells containing bacteria (other body parts can also be biopsied)
Complete blood count (CBC) showing anemia

This disease may also alter the results of the following tests:

Treatment

A person with Whipple's disease needs long-term antibiotic therapy to treat infections of the brain and central nervous system. A medicine called ceftriaxone is given through a vein (IV), followed by an antibiotic taken by mouth, such as trimethoprim -sulfamethoxazole. This antibiotic is taken for up to one year.

If symptoms come back during antibiotic use, the antibiotic or antibiotics may be changed.

Because signs of the disease can return after completing therapy, the patient should be closely followed by a doctor. Those who have nutritional deficiencies due to malabsorption will need dietary supplements.

Expectations (prognosis)

Without treatment, the condition is usually fatal. Treatment improves the chance of a good outcome.

Complications

Nutritional deficiencies
Weight loss
Reappearance of symptoms, suggesting drug resistance

Calling your health care provider

Call your health care provider if you have persistent abdominal pain and diarrhea.

If you are being treated for Whipple's disease, call your health care provider if symptoms worsen or do not improve, if symptoms reappear, or if new symptoms develop.

Review Date:12/19/2006
Reviewed By:D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network.

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