Whipple’s disease

Overview 

Whipple’s disease, a rare bacterial infection, disrupts the normal functioning of the small intestine, impairing the processing of fats and absorption of essential vitamins and nutrients. This malabsorption can result in nutritional deficiencies. Beyond its impact on the digestive system, Whipple’s disease has the potential to affect various organs, such as the brain, heart, eyes, joints, and other vital systems. The infection is attributed to exposure to Tropheryma whipplei bacteria present in soil and water. Without appropriate treatment, the disease can become severe or fatal. Fortunately, a regimen of antibiotics has proven effective in treating Whipple’s disease.

Left untreated, Whipple’s disease poses a serious threat to health, with potential complications extending to critical organs such as the brain, heart, and eyes. The infection disrupts the normal absorption of nutrients in the small intestine, leading to malabsorption and subsequent nutritional deficiencies. In addition to its impact on the digestive system, the bacteria responsible for Whipple’s disease, Tropheryma whipplei, can spread to the nervous system, joints, and other organs. The key to successful management lies in timely intervention with a course of antibiotics, which has demonstrated efficacy in treating this rare bacterial infection.

Symptoms 

Most patients with this disease experience a gradual onset of symptoms over many years. Some people experience symptoms years before the digestive symptoms that lead a diagnosis, such as joint discomfort and weight loss.

• Signs and symptoms (common): Whipple disease frequently manifests digestive signs and symptoms, which include: 

• • Anemia. 
  • Diarrhea. 
  • Fatigue. 
  • Abdominal pain, usually after eating. 
  • Joint pain. 
  • Weakness. 
  • Unexplained weight loss
    

• Signs and symptoms (less common): Signs and symptoms of Whipple disease might occasionally include: 

• • Chest pain. 
  • Confusion. 
  • Cough. 
  • Enlarged lymph nodes. 
  • Darkening of the skin in scars and sun–exposed areas. 
  • Difficulty walking. 
  • Fever. 
  • Issues with vision, such as inability to manage eye movement. 
  • Memory loss. 
  • Problem with balance. 

Whipple disease is normally manageable but has the potential to be fatal. In the event of any unexpected signs and symptoms, such as unexplained weight loss or joint pain, get in touch with a healthcare provider. Tests can be run by a healthcare provider to identify the source of the symptoms. 

Causes

Whipple’s disease, caused by the bacteria Tropheryma whipplei, is a rare infection with uncertain transmission mechanisms. Although the bacteria are found everywhere in the environment, the reasons behind why some individuals contract the infection while others do not remain unclear. Despite the presence of Tropheryma whipplei in the saliva and stool of non–infected individuals, those possessing the human leukocyte antigen B27 (HLA–B27) protein may be more susceptible to developing Whipple’s disease upon exposure to the bacteria. Individuals with the illness often exhibit compromised immune systems, making it challenging for their bodies to combat infections. The bacteria primarily impact the mucosal lining of the small intestine, creating lesions and damaging the villi. The origin and transmission of Tropheryma whipplei remain poorly understood, contributing to the rarity of Whipple’s disease, affecting fewer than 1 in 1 million people.

Risk factors 

Whipple disease risk factors are unclear because there is a lack of knowledge on the bacteria that cause the disease. Reports currently available suggest that it is more likely to affect:

• Age: It affects people at the age of 40 to 60 years old. 
• Gender: The condition mostly affects men. 
• Race: In North America and Europe, the disease primarily affects white people.
• Occupation: Farmers and other outdoor workers who frequently come into contact with wastewater and sewage.