Digestive Problems
Diseases: Small Bowel: Whipple's Disease
Whipple's disease is a disorder that affects many organs of the body. It is characterized by inflammatory cells infiltrating these organs. In the small intestine, these inflammatory cells (macrophages filled with a glycoprotein) infiltrate to such an extent that the villi are distended and very abnormally prominent; the lymph nodes in the abdomen also become very large. Whipple's disease is thought to be related to an infection, as bacteria (Tropheryma Whippelli) has been seen in some patients. The inflammatory cells cause a mechanical blockage to the villi, and prevent transport of nutrients.
Whipple's disease can also affect the skin, joints, nervous system and heart. Patients can present with a long history of joint problems, fever, diarrhea weight loss, enlarged lymph nodes, skin pigmentation and intermittent exacerbations of abdominal pain.
Investigation with blood tests can reveal features of malabsorption or malnutrition. Endoscopic biopsy sampling of the small bowel lining reveals the typical inflammatory cells (macrophages) infiltrating the mucosa.
Patients with Whipple's disease are treated with antibiotics for several months, and usually go into remission; some may have relapses.