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Whipple's disease is a rare condition that prevents the small intestines from properly absorbing nutrients. This is called malabsorption.
Causes
Whipple's disease is caused by infection from bacteria called Tropheryma whippelii. The disorder mainly affects middle-aged white men.
Whipple's disease is extremely rare. Risk factors are unknown.
Symptoms
Symptoms usually start slowly. Joint paint is the most common initial symptom. After that, often several years later, symptoms of gastrointestinal (GI) infection develop. Other symptoms may include:
Abdominal pain
Diarrhea
Fever
Gray to brown skin color
Joint pain
Memory loss
Mental changes
Weight loss
Exams and Tests
Possible signs:
Enlarged lymph glands
Fatty stools
Gastrointestinal (GI) bleeding
Heart murmur
Swelling in body tissues (edema)
Tests to diagnose Whipple's disease may include:
Complete blood count (CBC)
Polymerase chain reaction (PCR) testing of the affected tissue for Tropheryma whippelii
Small bowel biopsy
Upper GI endoscopy (viewing the intestines with a flexible, lighted tube in a process called enteroscopy )
This disease may also change the results of the following tests:
Albumin levels in the blood
Unabsorbed fat in the stools (fecal fat)
Intestinal absorption of a type of sugar (d-xylose absorption)
Treatment
People with Whipple's disease need to take long-term antibiotics to cure any infections of the brain and central nervous system. An antibiotic called ceftriaxone is given through a vein (IV). It is followed by another antibiotic (such as trimethoprim-sulfamethoxazole)
If symptoms come back during antibiotic use, the antibiotic treatment may be changed.
Your health care provider should closely follow your progress, 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.
Outlook (Prognosis)
Without treatment, the condition is usually fatal. Treatment relieves symptoms and can cure the disease.
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