What Is Whipple’s Disease?
Whipple's disease is a rare bacterial disease that can affect multiple systems throughout the body, potentially causing a wide range of symptoms.
It most often affects the gastrointestinal system — the small intestine, in particular — before spreading to other areas of the body.
Causes and Incidence
Whipple's disease is caused by the bacteriaTropheryma whipplei.
It's unclear howT. whippleigets into people, but it may be ingested in particles of fecal matter.
The bacteria live in soil and wastewater, and farmers and people who work outdoors are most likely to contract the disease, according to a 2013 article in the journalRheumatic Disease Clinics of North America.
When it gets into the body,T. whippleicauses internal sores (lesions) and tissue thickening in the small intestine.
This damage prevents the intestinal lining from adequately absorbing nutrients, eventually leading to malnutrition.
Whipple's disease is rare, and there's no consensus regarding how many people it affects.
Some research suggests there are as few as 12 new cases of the disease across the globe each year.
Other studies point to an annual incidence of less than one in a million people, according to a 2008 report inThe Lancet Infectious Diseases.
Yet between 1.5 and 7 percent of the general population may carryT. whippleiwithout experiencing any symptoms, according to the 2013 article.
The disease can affect people of any age, but the average age of diagnosis is between 48 and 54. It's far more common in men than in women, by a ratio of about eight to one.
Signs and Symptoms of Whipple's Disease
There are two phases of Whipple's disease.
In the initial phase, people most commonly experience joint pain, fever, fatigue, and arthritis.
Gastrointestinal symptoms — particularly diarrhea, weight loss, and abdominal pain — are the most common symptoms in the late phase of the disease, which typically occurs years after the initial phase.
Migratory arthralgia – pain that usually involves different joints at different times, as if "migrating" from one joint to another – is another common sign of Whipple's disease.
The late phase can also affect numerous other body systems, especially the eyes, heart, and central nervous system. A wide range of symptoms may result, including:
- Darkened skin
- Fatty or bloody stools
- Loss of appetite
- Enlarged lymph nodes
- Vision problems
- Memory problems
- Facial numbness
- Muscle weakness and difficulty walking
- Joint stiffness
- Hearing problems
- Chronic cough
- Chest pain
- Heart failure
Left untreated, Whipple's disease can cause serious complications, including long-lasting nutritional deficiencies, heart damage, and brain damage. It can eventually result in death.
Diagnosis and Treatment of Whipple's Disease
Whipple's disease is typically diagnosed only after gastrointestinal symptoms arise, according to the 2013 article.
Diagnosis begins with your doctor getting your medical history and conducting a physical examination, which can help identify signs of Whipple's disease.
Initial assessments may also involve:
A definitive diagnosis of Whipple's disease requires a biopsy of an affected organ — in which a tissue sample is viewed under a microscope — as well as a PCR test on the tissue.
Video: What is the Whipple Procedure - Mayo Clinic
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