Whipple’s Disease

What is Whipple’s disease?

This is a rare systemic infectious medical condition that most often affects the gastrointestinal system. It is also known as your digestive system and includes your mouth, tongue, pharynx, esophagus, liver, stomach, gallbladder, pancreas, small and large intestine, and your rectum and anus. It was first describe in 1907 by George Hoyt Whipple, physician. Whipple’s disease is most likely to affect Caucasian men between the ages of thirty and sixty.

Whipple’s Disease Symptoms

There are many different early symptoms which can include:

• Weight loss that is associated with the malabsorption of nutrients your body needs
• Abdominal cramps that may be worse after a meal
• Fatigue
• Diarrhea
• Pain and inflammation in your joints especially in your wrists, ankles, and knees

There are some people whose blood levels may should anemia and they feel fatigued most of the time because the infection makes it hard for your intestines to absorb the nutrients your body needs.

As the medical condition progressed you may experience:

• Having a low grade fever
• Changes in gait
• Swollen lymph nodes but these can also occur in the early stages of the disease
• Cough
• Difficulties with breathing
• Anemia

Some of the less common symptoms and signs may include:

• Hyperpigmentation in areas of your skin that are exposed to the sun. Any scars you may have may also darken
• Chest pain
• Spleen that is enlarged
• Lack of control over the movements of your eye and other visual impairments
• Seizures
• Confusion and/or memory loss

Most of the symptoms associated with Whipple’s disease will slowly develop over many years but in some people some symptoms like weight loss and joint pain may develop years before the gastrointestinal symptoms start to develop.

Whipple’s Disease Causes

Whipple’s disease is caused by the bacterium Tropheryma Whipplei. Although it normally starts in your intestines it can spread to your whole body and become systemic. At this point it may have already created permanent damage of your central nervous system or organs. When this bacterium in your system if normally affects the mucosal lining of your small intestine causing small lesions to form on your intestinal wall and can damage the villi, which are the fine hair-like projections that line your small intestine.

Scientist do know much about this bacterium that causes Whipple’s disease and are not sure how it is transmitted to humans or where it even comes from but it does seem to readily present in the environment. One thing that is known is that not everyone who carries this bacterium will develop Whipple’s disease. There are some researchers who feel that there might be a genetic defect in a person’s immune system response who have Whipple’s disease. If they have this genetic defect it could make them more susceptible to becoming ill if they are exposed to this bacterium.

Whipple’s Disease Pictures

Collection of Photos, Images and Pictures of Whipple’s Disease…

High magnification micrograph of Whipple’s Disease

Whipple’s Disease Diagnosis

There are many different ways that can be used to diagnosis Whipple’s disease but because it is such a rare disease not many physicians think to look for it when they have a patient with the above symptoms in their office. The symptoms of Whipple’s disease can also indicate other medical conditions. A physician can do a biopsy of a swollen lymph node and/or a biopsy of your intestines if they suspect you have Whipple’s disease. By doing these biopsies can confirm if there is the presence of the bacteria that causes Whipple’s disease or not. The physician may also do a CBC (complete blood count) which can show if you have anemia or not, which is a symptom of Whipple’s disease.

Treatment

Whipple’s disease can be treated but if it is not diagnosed it can be fatal. If it is diagnosed early enough it can be treated successfully with long courses of antibiotics. You will usually be taking antibiotics for at least twelve months or longer in order to kill the bacteria that are involved in causing this rare medical condition. The bad thing is that even with treatment it can recur. In addition to taking antibiotics on a daily basis some may require other medications to help deal with the symptoms of Whipple’s disease. To make up for the deficits in your mineral and vitamin absorption you may have to take vitamins or nutritional supplements. If you are experiencing joint pain the physician may have you take over-the-counter pain relievers or prescribe a stronger medication to help with your pain.

Although you will have to be on antibiotic treatment for at least twelve months or longer to kill the bacteria you should start to see relief from the symptoms in the first seven days or so and the symptoms will be completely gone within thirty days. If you do not have any nervous system or brain complications you will normally recover completely after the full course of antibiotics. When the physician chooses which antibiotic to use they look for one that will not only wipe out the intestinal tract infection but will also cross the blood-brain barrier to make sure that if there is any bacteria in your central nervous system or brain that it will also be eliminated. Your physician will monitor you during the period of time you are taking antibiotics and will determine when you can stop them. If your body starts to show resistance to a particular medication or your symptoms are not improving the physician will change the medication.

Standard care treatment

For standard cases the physician will usually start with fourteen days of ceftriaxone (Rocephin) intravenously and then start on an oral course of sulfamethoxazole-trimethoprim (SMX-TMP) which is a combination of Bactrim and Septra for twelve to twenty-four months. If you do not take it at least twelve months it could lead to a relapse.

Severe care treatment

If you are showing neurologic symptoms the physician may immediately start you on a twelve to eighteen month course of oral doxycycline (Vibramycin) and combine it with hydroxychloroquine (Plaquenil), which is an anti-malarial medication. The physician will also start you on long-term antibiotics that can enter your brain and cerebrospinal fluid. The standard antibiotic that is used is the same one that is used in standard cases, SMX-TMP.