Whipple's disease

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Obesity, Sleep & Internal medicine
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Whipple's disease
Micrograph of Whipple's disease showing foamy macrophages in the lamina propria of the small intestine.
Synonyms	Intestinal lipodystrophy
Pronounce	N/A
Specialty	Gastroenterology, Infectious disease
Symptoms	Diarrhea, weight loss, abdominal pain, arthritis, fever
Complications	Malabsorption, neurological symptoms
Onset	Typically in middle-aged men
Duration	Chronic
Types	N/A
Causes	Tropheryma whipplei infection
Risks	Occupational exposure to soil and animals
Diagnosis	Biopsy of the small intestine, polymerase chain reaction (PCR) testing
Differential diagnosis	Celiac disease, Crohn's disease, tuberculosis
Prevention	N/A
Treatment	Antibiotics such as ceftriaxone followed by trimethoprim/sulfamethoxazole
Medication	N/A
Prognosis	Good with treatment, but can be fatal if untreated
Frequency	Rare
Deaths	N/A

Whipple's disease, also known as intestinal lipodystrophy, is a rare infectious disease caused by the bacterium Tropheryma whipplei. This condition primarily affects the small intestine but can also involve other parts of the body such as the heart, brain, and joints. Whipple's disease was first described by Dr. George Hoyt Whipple in 1907 and is characterized by malabsorption, weight loss, joint pain, and other systemic symptoms.

T.Whipplei

Symptoms

The symptoms of Whipple's disease can vary widely depending on which organs are affected. Common symptoms include chronic diarrhea, abdominal pain, weight loss, joint pain, fever, and fatigue. Some individuals may also experience neurological symptoms such as confusion, memory loss, and vision problems.

Causes

Whipple's disease is caused by infection with the bacterium Tropheryma whipplei. It is believed that the bacterium is acquired through oral ingestion, although the exact mode of transmission is not well understood. Individuals with weakened immune systems are at higher risk of developing Whipple's disease.

Diagnosis

Diagnosing Whipple's disease can be challenging due to its nonspecific symptoms. A combination of clinical evaluation, imaging studies, blood tests, and biopsy of affected tissues is usually necessary to confirm the diagnosis. The gold standard for diagnosis is the identification of Tropheryma whipplei in biopsy samples using special staining techniques.

Treatment

The primary treatment for Whipple's disease is long-term antibiotic therapy. A combination of antibiotics such as ceftriaxone, doxycycline, and hydroxychloroquine is typically used to eradicate the bacterium. In some cases, surgery may be necessary to remove infected tissue or repair damage caused by the disease.

Prognosis

With early diagnosis and appropriate treatment, the prognosis for Whipple's disease is generally good. However, if left untreated, the disease can be fatal. Regular follow-up with healthcare providers is important to monitor for any signs of disease recurrence or complications.

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