Although first described by a pathologist named George Whipple in 1907, the bacterium causing Whipple's disease was not successfully isolated and established in culture until the year 2000. To this day, little is known about Whipple's disease and its disease-causing bacteria. Whipple's disease is a rare malabsorption disease that affects one in a million individuals each year, according to the Mayo Clinic.
Identification
Whipple's disease is an infection by the bacterium Tropheryma whipplei, which primarily affects the gastrointestinal tract. The bacterium impairs the digestive system's ability to properly metabolize fats, which leads to decreased absorption of vital proteins, minerals and vitamins. The disease has the ability to spread to other parts of the body, including the central nervous system, heart, eyes and joints. The disease is quite treatable with antibiotic therapy, but deadly if left untreated.
Symptoms
The primary symptoms of an infection by the bacterium Tropheryma whipplei affect the digestive system, resulting in diarrhea, abdominal pain, cramping and weight loss. Other symptoms include joint inflammation, fatigue, weakness and anemia (low red blood cell count). If the bacterium spreads to the central nervous system, symptoms may include confusion, abnormal muscle movement in the face, seizures, memory loss and visual impairments. Symptoms generally develop slowly over the course of several years and progressively get worse without proper treatment.
Causes and Risk Factors
Not a lot of information is known about the Tropheryma whipplei bacterium. The bacterium is readily present in the environment, but scientists are unsure of how exactly the bacteria is spread to humans or where it comes from. The bacterium initially takes up residence and attacks the mucosal lining of the small intestines before spreading to other organs in the body, if at all. Since little information is known, risk factors are not clearly defined. However, data does show that Whipple's disease affects more men than women, generally targets 30- to 60-year-olds, and is most often found in Caucasian individuals in North America and Europe.
Diagnosis
Since symptoms develop slowly, Whipple's disease is often diagnosed in later stages of the disease when symptoms are more severe. Common signs of the disease include enlarged lymph glands, edema (swelling), fatty stools and gastrointestinal bleeding. Diagnosis starts with a physical exam to determine if further testing is needed. When Whipple's disease is suspected, a biopsy of the small intestines is taken along with an enteroscopy, a procedure to visualize the small bowel. Additional blood tests are also taken to detect anemia and albumin levels (a transport protein in the blood).
Treatment
Whipple's disease is an easily treatable disease, but is fatal if left untreated. Long-term antibiotic treatment is the preferred method of treatment. This type of treatment course generally involves a hospital stay for the first few weeks in which antibiotics are administered intravenously. This is followed by one to two years of outpatient antibiotic treatment along with any necessary vitamin or mineral supplements if required by the individual. The lengthy treatment is to ensure that the disease is completely eradicated from the body and to prevent relapses. Fortunately, symptoms are quickly relieved in only a few days for some and in a few weeks for others.
