Whipple’s disease
Causes of Whipple’s disease
Whipple’s disease (intestinal lipodis-trophy, mesentery lipogranulomatosis, intestinal lipodystrophy) is a fairly rare disease. It is systemic, that is, it covers several systems of the body. It has an infectious nature.
Whipple’s disease mainly affects the small intestine and nearby lymph nodes, in addition, the disease can affect the nervous system, digestive system, cardiovascular system.
Whipple’s disease affects, as a rule, men aged 40-55 years.
The causes of Whipple’s disease are the defeat of the human body by the bacterium Tropheryma whippelii, as well as weak immunity, which is unable to suppress the pathogen. In healthy people, in the absence of symptoms of the disease, this bacterium can be excreted with saliva.
Symptoms of Whipple’s disease
The clinical manifestations of Whipple’s disease – due to the fact that it affects many body systems – are very diverse.
Muscles and joints are usually the first to be affected. There are migrating pains in the muscles and joints, inflammation, swelling, swelling of the joints, pain when probing, compaction in the muscles. At the same time, arthritis is acute, and they can precede multiple manifestations of the disease for several years.
Enlargement of lymph nodes, their mobility, soreness – the next sign of the disease. Both superficial and deep lymph nodes are involved. The process is accompanied by an increase in body temperature. There are areas of hyperpigmentation of the skin – especially in the area around the eyes, cheekbones, on the face and in areas that are exposed to sunlight. This is due to a malfunction of the adrenal glands.
When the disease reaches the advanced stage, the following symptoms are added. The gastrointestinal tract is affected: diarrhea begins (light, bubbling, with an extremely unpleasant odor, sometimes with a greasy coating that is poorly washed off the toilet), abdominal pain (especially after eating), increased gas formation, impaired absorption of nutrients in the intestine, sometimes this leads to a sharp weight loss. Next, there may be: lung lesions – wet cough, chest pain, pleurisy, high fever; heart lesions (endocarditis); nervous system damage – convulsions, limb paralysis, depression, sleep disorders, speech disorders, memory loss, dementia; eye damage – chicken blindness, conjunctivitis.
For diagnostics , the following are used:
interview of the patient, analysis of complaints, analysis of the history of the disease and lifestyle, examination by a doctor;
laboratory tests: clinical blood analysis, biochemical blood analysis, coprogram (stool analysis), PCR of saliva and gastrointestinal contents;
identification of parasites – worms, ascariids, pinworms, giardia, opisthorchiasis;
radiography of the abdominal cavity;
Ultrasound of the abdominal cavity and lymph nodes;
CT of abdominal organs;
endoscopic examination of the intestine with biopsy;
echocardiography;
consultations of narrow specialists.
Treatment of Whipple’s disease
The disease is treated for a long time, at least 2 years, with mandatory intermediate and final control.
Treatment includes:
antibacterial therapy;
anti-inflammatory therapy;
intake of digestive enzymes;
diet (table No. 5 by Pevsner);
taking vitamins;
symptomatic therapy.
Without treatment, a few years after the onset of the second stage (symptoms from the gastrointestinal tract), the patient dies due to heart lesions, adrenal insufficiency, cerebral edema, anemia, dysfunction of many organs.
To prevent relapses of the disease, you should undergo regular monitoring of the effectiveness of treatment, follow a diet, take multivitamins and enzymes.
