Whipple’s Disease (Intestinal Lipodystrophy)

Whipple’s disease is a malabsorption disorder caused when the lining of the small intestine is damaged by Tropheryma whippelii infection. It is also called intestinal lipodystrophy.

  • Infection by bacteria called Tropheryma whippelii is the cause of Whipple’s disease.
  • Diarrhea, darkening of skin, and inflammation and pain in the joints accompanied by fever, are usual symptoms.
  • Biopsies of the lining of the small intestine help diagnose the condition.
  • The disease has a progressive nature, and if not treated, a fatal outcome may result.
  • The disease can be successfully treated with antibiotic drug therapy but there are chances of recurrence.

Whipple’s disease is prevalent among white men in the age group of 30- 60 years. The infection by Tropheryma whippelii mainly affects the small intestine but it can involve a number of other organs including the heart, brain, lungs, eyes and the joints.

Symptoms

Symptoms of this disease are diarrhea, darkening of the skin, and inflammation and pain in the joints, accompanied by fever. Abdominal pain also may be present. Significant weight loss may result from malabsorption of nutrients from food. Anemia caused by the deficiency of iron and vitamins, may lead to weakness and fatigue. When the lungs are affected by the disease, the pleural membranes enclosing the lungs become inflamed, and fluid accumulation between the layers of the pleural membrane, termed pleural effusion, occurs. Pain while breathing and cough are the symptoms of this condition. Enlargement of lymph nodes occur. Abnormal heart sounds called murmurs may result when the heart is affected. When the disease progresses to the brain, symptoms such as loss of memory, confusion and uncontrollable, random eye movements, may appear. The progression of the disease may culminate in death in the absence of timely medical intervention.

Diagnosis and Treatment

When a person displays the typical symptoms of Whipple’s disease, further investigative procedures are conducted to confirm the disease. Biopsies of the tissue gathered by an endoscope from the small intestine, and a sample from a lymph node which is enlarged, help detect the presence of the bacteria.

Long term antibiotic therapy is the effective treatment for Whipple’s disease. Intravenous administration of ceftriaxone is followed by oral drug therapy with sulfamethoxazole or trimethoprim for a period of 12 months. The antibiotic treatment is effective in curing the disease but recurrence is a possibility.

 

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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