Whipple's Disease Health Article

Diagnosis

Diagnosis of Whipple's disease is difficult, and is commonly suspected only if the patient presents with malabsorption symptoms. Then, a small-bowel biopsy can be made to locate the presence of the bacteria and confirm the diagnosis. However, symptoms can vary greatly depending on the areas of the body that are affected, and up to a third of sufferers do not present with malabsorption ailments.

Treatment team

Once diagnosed, the treatment of Whipple's disease is often straightforward, and can be monitored with minor hospital procedures. However, due to the rarity of the disease and the recent developments in studying the disorder it is recommended that contact be made with specialized centers of research or a neurologist.

Treatment

Whipple's disease generally responds well to antibiotic therapy. The recommended treatment is two weeks of intravenous antibiotics followed by a year or more of oral antibiotics. If the malabsorption symptoms are pronounced, the patient may require intravenous fluids and electrolytes, and other dietary supplements. A diet high in calories and protein is often recommended, and should be monitored by a physician.

Recovery and rehabilitation

When treated, symptoms such as diarrhea and fever can resolve within days, and most symptoms typically improve within a few weeks. In most cases, symptoms of the disorder are lessened or ameliorated by treatment. The progress of therapy can be checked by biopsy of the small intestine. In about one third of cases, the disease relapses and is more likely to affect the central nervous system than the initial infection. Periodic monitoring over several years, therefore, is essential to prevent neurological damage.

Clinical trials

Although as of early 2004, there were no ongoing clinical trials in the United States specific for Whipple's disease, the National Institute of Diabetes and Digestive and Kidney Diseases supports research for similar disorders.

Prognosis

If untreated, Whipple's disease can be fatal, but when treated with antibiotic therapy most patients experience rapid recovery and lasting remission. However, up to a third of patients may suffer a relapse.

Special concerns

Knowledge of Whipple's disease is rapidly evolving, and there have been many recent developments that may lead to new diagnostic options and new treatments in the near future.

PERIODICALS

Marth, Thomas, and Dider Raoult. "Whipple's disease," Lancet 361, no. 9353 (January 18, 2003): 239–247.