Whipple disease

A form of intestinal malabsorption (an inability to absorb nutrients from the intestine) described in 1907 by the pathologist and Nobel laureate George H. Whipple in a medical missionary who first developed arthritis and then weight loss, cough, fever, diarrhea, hypotension (low blood pressure), abdominal swelling, increased skin pigmentation, and severe anemia. The disease has been discovered to be due to a previously unknown type of bacteria, now named Tropheryma whippelii, which was reported in the year 2000 to have been grown in the laboratory, opening the way for the development of a simple blood test to diagnose the disease. It is treated with antibiotics. Some patients relapse and need long-term, even life-long, treatment.

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a malabsorption syndrome caused by infection with Tropheryma whippelii, characterized by diarrhea, steatorrhea, skin pigmentation, arthralgia and arthritis, lymphadenopathy, and sometimes central nervous system involvement with oculofacioskeletal or oculomasticatory myorhythmia. The intestinal mucosa is infiltrated with macrophages containing PAS-positive material that is the remnants of microorganisms that invaded the lamina propria. Called also intestinal lipodystrophy and intestinal lipophagic granulomatosis.

Whipple disease; confocal microscopy of a small intestine biopsy sample stains blue where a fluorescent probe for Tropheryma whipplei nucleic acid hybridizes to the bacteria. Human cell nuclei are stained fluorescent green and vimentin in human mesenchymal cells is stained red. Bacteria are localized to the lamina propria and are abundant in the extracellular spaces.