Whipple disease


Whipple Disease

Description, Causes and Risk Factors:

Alternative Names: Morbus Whipple, intestinal lipodystrophy.

Abbreviation: WD.

ICD-9: 040.2.

Whipple's disease is a rare malabsorption disorder, which means it interferes with the body's ability to absorb certain nutrients from the digestive track. The disease causes weight loss, irregular breakdown of carbohydrates and fats, resistance to insulin, and malfunctions of the immune system. The disease affects primarily middle-aged, Caucasian men, and the onset of symptoms is usually slow. When recognized and treated, Whipple's disease can be cured; untreated, the disease is usually fatal.

Whipple's disease is a chronic infectious disorder in which almost all organ systems can be invaded by the rod-shaped bacterium - Tropheryma whipplei (T. whipplei). Anyone can get Whipple's disease, but it is more common in middle-aged Caucasian men. Not much is known about the bacterium. Although it seems readily present in the environment, scientists do not really know where it comes from or how it's transmitted to humans. Not everyone who carries the bacterium 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 susceptible to becoming ill when exposed to the bacterium.

The disease may take many years to fully develop. In the beginning, the bacteria may attack patient's small intestine leading to gradual proliferation towards other organs of the body.

The origin of the bacteria is still not known to scientists nor do they know how the humans catch the infection from them. Some scientists hypothesize that it is not the bacteria alone responsible for the disease rather it may be due to some genetic disorder in the immune system of the patient due to which a person easily falls prey to it.

The disease is a rare one and only one in a million becomes its victim. The full treatment extends to one to two years to full root out infection and bacteria. But the patient gets relief within some days after starting the treatment.

Symptoms:

Common symptoms include:

    Chronic diarrhea.

  • Weight loss.

  • Abdominal pain and bloating.

  • Fatigue.

  • Low-grade fever.

Neurological symptoms Include:

    Enlarged lymph nodes.

  • Skin darkening.

  • Vision problems.

  • Headache.

  • Confusion.

  • Seizures

  • Muscle weakness and twitching.

  • Memory problems.

Diagnosis:

Differential Diagnosis: Seronegative polyarthritis, vasculitis, malabsorption syndrome, endocarditis, cerebrovascular disease, dementia, HIV infection.

Whenever the suspicion arises that a patient may suffer from Whipple's disease, the best way to check this possibility is a histologic study of small intestinal biopsies. For this purpose a mucosal biopsy particles should be obtained from the most distal part of the duodenum which can be reached with the endoscope. If biopsies of the small intestine do not confirm the diagnosis, your doctor might biopsy an enlarged lymph node or perform other tests if you have neurological symptoms, such as seizures. A DNA-based test known as polymerase chain reaction (PCR), which is available at some medical centers, can detect Tropheryma whipplei bacteria in biopsy specimens or spinal fluid samples.

Treatment:

Because Whipple's disease is primarily considered a gastrointestinal disorder, gastroenterologists, specialists in the treatment of digestive diseases are the type physician that generally treat this disorder.

A medicine called ceftriaxone is given intravenously. It is followed by an antibiotic (such as trimethoprim-sulfamethoxazole) taken by mouth for up to one year. If symptoms come back during antibiotic use, the antibiotic treatment may be changed.

To manage joint pain, your doctor may recommend a nonsteroidal anti-inflammatory medication, such as ibuprofen (Motrin, Advil, others), as well.

If you have severe neurological symptoms or a long-lasting high fever, your doctor may also prescribe corticosteroids, which may help ease symptoms and reduce inflammation.

Even after successful treatment, Whipple's disease can recur. Doctors usually advise regular checkups. If you've experienced a recurrence, you'll need to repeat antibiotic therapy.

Your health care provider should closely follow you, because signs of the disease can return after you finish therapy. Those who have nutritional deficiencies from malabsorption will also need to take dietary supplements.

Note: The following drugs and medications are in some way related to, or used in the treatment. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

Disclaimer: The following tests, drugs and medications, surgical procedures are in some way related to, or used in the treatment. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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