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Whipple's disease is a rare systemic disease with a chronic course. This condition is characterized by the presence of lipid and glycoprotein aggregates in the mucosa.intestinal lining and lymph nodes, malabsorption, arthralgia, diarrhea, abdominal pain and weight loss.
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Whipple's disease primarily affects the small intestine, but other parts of the body such as the joints, lungs, heart, spleen, liver, kidneys, skeletal muscles, and central nervous system are not spared. Whipple's disease results from a chronic infection with the gram-positive bacterium Tropheryma whippelii.
The main feature of the clinical picture is the appearance of a large number of macrophages loaded with lipids and glycoprotein in the mucous membrane of the small intestine, in the lymphatic tissues of the mesentery and in the lymph nodes. The reasons why this happens are still unknown and are currently the subject of scientific research and debate.
What causes Whipple's disease? Whipple's disease is caused by Tropheryma whippelii (called Tropheryma whipplei until 2001). This rod-like bacterium is widely distributed in the environment, but is found primarily in water treatment plants. The bacterium Whippelii Tropheryma is passed through the stool of healthy carriers and people suffering from Whipple's disease.
The conditions that contribute to the onset of infection are not yet known.
In the countries of Central Europe, the estimated incidence is less than one case per million per year.
However, an acquired and genetic immunological predisposition was found in etiopathogenesis: in Whipple's disease, defects in some HLA gene loci and a decrease in the immune response of T-lymphocytes (in particular, Th1 type) are found.
Learn MoreThe symptoms of Whipple's disease are very ambiguous, as they differ depending on which organs are most affected and the stage of the disease. Some manifestations are more common than others, even if they are not necessarily present in all patients; These include:
Learn MoreWhipple's disease is a disease in which almost all organs can be affected by Tropheryma whippleii. The site most affected by the disease is the mucosa of the small intestine, but other organs are also involved, including the spleen, heart, lungs, liver, kidneys, joints, eyes, and central nervous system.
Learn MoreWhipple's disease can lead to a recently discovered complication called immune reconstitution inflammatory syndrome (IRIS). It occurs in some patients after initiation of cefdinir therapy due to a recurrence of inflammation that no longer responds to antibiotics (note: in most cases, antibiotics are effective in killing bacteria). It should be noted that inflammatory immune reconstitution syndrome is not a recurrence of Whipple's disease, but a separate complication. Whipple's disease, not receiving adequate antibiotic treatment, steadily progresses and leads to death.
Cardiac symptoms (eg, negative endocarditis, cardiac pericarditis, and valvulopathy) and neuropsychiatric disorders (cognitive dysfunction, ophthalmoplegia, and facial clonic contractions) are also occasionally observed.
Whipple's disease is diagnosed by histological examination after biopsy of a sample of omnicef nodes or intestines. The analysis allows to identify rod-shaped bacteria (phagocytized or free) under an electron microscope, as well as to identify other specific changes, such as the presence - at the level of the own plate of the mucous membrane of the small intestine or other tissues - swollen macrophages with a positive Schiff's reagent. Culture studies, genetic tests, and special molecular tests, including PCR (polymerase chain reaction) on extraintestinal tissue samples such as cerebrospinal fluid, lymph, or synovial fluid, may be used to definitively confirm the diagnosis.
Treatment for Whipple's disease involves the use of antibiotics to kill bacteria, first intravenously and then for 12 months of oral therapy.
The most widely used drugs are tetracycline, chloramphenicol, chlortetracycline, sulfasalazine, ampicillin, penicillin, and trimethoprim/sulfamethoxazole. Currently, the most common therapy for Whipple's disease is the combination of trimethoprim + sulfamethoxazole. Another recommended drug combination, alternatively, consists of cephalosporins or penicillins followed by tetracycline. The treatment protocol is long-term, meaning it must last for at least one year, after which maintenance antibiotic therapy can be started. Usually antibiotic therapy correlates with good results.
It is possible that relapses may occur after resolution of omnicef.
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Left untreated, Whipple's disease progresses and leads to death as a result of decay and/or damage to the central nervous system. On the other hand, with adequate antibiotic therapy, improvement from a clinical point of view is quite fast. Whipple's disease has been known for over a hundred years, but the infectious agent that causes it is still not well understood. Numerous systemic manifestations of the disease dictate the need for a complex comprehensive diagnosis, the final stage of which is a biopsy of the tissues of the affected part of the small intestine.
Characteristics of Whipple's disease. Whipple's disease belongs to the group of infectious diseases. In this pathological process, damage to several systems of the human body develops at once. The infection is localized in the intestine, but it also manifests itself with extraintestinal signs.
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The intestines (small intestine) and nearby lymph nodes are primarily affected. Then, in the course of the development of the pathology, other systems are involved: cardiovascular, nervous, musculoskeletal. This is a fairly rare disease: according to statistics, it occurs only in one person in a million. This syndrome was first described in 1907, named after the author, American pathologist Whipple George Hoyt.
The disease can occur at any age, but most often affects people of the middle age group from 40 to 55 years. Women get sick five times less than men. This disease belongs to the group of hereditary. The causative agent of Whipple's disease is the little-studied bacterium Tropheryma whippelii. Some researchers believe that not only the presence of an infectious agent plays a role, but also other predisposing factors. These include:
