- By sahlhealth
- May 18, 2021
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Whipple disease is a rare bacterial infection that most often affects your joints and digestive system. Whipple disease interferes with normal digestion by impairing the breakdown of foods, such as fats and carbohydrates, and hampering your body’s ability to absorb nutrients.Whipple disease can also infect other organs, including your brain, heart and eyes.Without proper treatment, Whipple disease can be serious or fatal. However, a course of antibiotics can treat Whipple disease.
Common signs and symptoms
-Digestive signs and symptoms are common in Whipple disease and may include:
- Abdominal cramping and pain, which may worsen after meals
- Weight loss, associated with the malabsorption of nutrients
- Other frequent signs and symptoms associated with Whipple disease include:
- Inflamed joints, particularly the ankles, knees and wrists
Less common signs and symptoms
-In some cases, signs and symptoms of Whipple disease may include:
- Enlarged lymph nodes
- Skin darkening (hyperpigmentation) in areas exposed to the sun and in scars
- Chest pain
- Enlarged spleen
Neurological signs and symptoms may include:
- Difficulty walking
- Visual impairment, including lack of control of eye movements
- Memory loss
-Symptoms tend to develop slowly over many years in most people with this disease. In some cases, symptoms such as joint pain and weight loss develop years before the digestive symptoms that lead to diagnosis.
Treatment for standard cases
-In most cases, Whipple disease therapy begins with two to four weeks of intravenous (IV) ceftriaxone or penicillin. Following that initial therapy, you'll likely take an oral course of sulfamethoxazole-trimethoprim (Bactrim, Septra), for one to two years.Possible side effects of ceftriaxone and sulfamethoxazole-trimethoprim include: allergic reactions, mild diarrhea, or nausea and vomiting.
-Other medications that have been suggested as an alternative in some cases include :oral doxycycline (Vibramycin Monodox), others combined with the antimalarial drug hydroxychloroquine (Plaquenil), which you'll likely need to take for one to two years.Possible side effects of doxycycline include: loss of appetite, nausea, vomiting and sensitivity to sunlight. Hydroxychloroquine may cause loss of appetite, diarrhea, headache, stomach cramps and dizziness.
- Your symptoms should improve within one to two weeks of starting antibiotic treatment and go away entirely within about one month.But even though symptoms improve quickly, further laboratory tests may reveal the presence of the bacteria for two or more years after you begin taking antibiotics. Follow-up testing will help your doctor determine when you can stop taking antibiotics. Regular monitoring can also indicate development of resistance to a particular drug, often reflected in a lack of improvement of your symptoms.Even after successful treatment, Whipple disease can recur. Doctors usually advise regular checkups. If you've experienced a recurrence, you'll need to repeat antibiotic therapy.
-Because of the nutrient-absorption difficulties associated with Whipple disease, your doctor may recommend taking vitamin and mineral supplements to ensure adequate nutrition. Your body may require additional vitamin D, folic acid, calcium, iron and magnesium.
-Whipple disease is caused by a type of bacterium called Tropheryma whipplei. The bacteria affect the mucosal lining of your small intestine first, forming small lesions within the intestinal wall. The bacteria also damage the fine, hairlike projections (villi) that line the small intestine.Not much is known about the bacteria. Although they seem readily present in the environment, scientists don't know where they come from or how they're spread to humans. Not everyone who carries the bacteria develops the disease. Some researchers believe that people with the disease may have a genetic defect in their immune system response that makes them more likely to become sick when exposed to the bacteria.
*Whipple disease is extremely uncommon, affecting fewer than 1 in 1 million people.
-Because so little is known about the bacteria that cause Whipple disease, risk factors for the disease haven't been clearly identified. Based on available reports, it appears more likely to affect:
- Men ages 40-60
- White people in North America and Europe
- Farmers and other people who work outdoors and have frequent contact with sewage and wastewater
-The lining of your small intestine has fine, hairlike projections (villi) that help your body absorb nutrients. Whipple disease damages the villi, impairing nutrient absorption.Nutritional deficiencies are common in people with Whipple disease and can lead to fatigue, weakness, weight loss and joint pain.Whipple disease is a progressive and potentially fatal disease. Although the infection is rare, associated deaths continue to be reported, due in large part to late diagnoses and delayed treatment. Death often is caused by the spread of the infection to the central nervous system, which can cause irreversible damage.