- 13 Downloads
Surgery may be performed to remove infected heart valves and joints in rare complicated cases.
The role of immunomodulatory treatment is promising but is limited by experience.
Nutritional support is a critical part of treatment, especially in patients with diarrhea and weight loss due to malabsorption.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 3.O’Duffy JD, Griffing WL, Li CY, et al.: Whipple’s arthritis: direct detection of Tropheryma whippelii in synovial fluid and tissue. Arthritis Rheum 1999, 42(4):812–817. In this paper, authors discuss the presence of T. whippelii in synovial fluids and membranes of patients who presented primarily with joint symptoms.PubMedCrossRefGoogle Scholar
- 6.Whipple GH. A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acid in the intestinal and mesenteric lymphatic tissues. Johns Hopkins Hosp Bull 1907, 18:382–391. This is the first case report of the heretofore unknown disease, published by George Whipple.Google Scholar
- 7.Ramzan NN, Loftus Jr E, Burgart LJ, et al.: Diagnosis and Monitoring of Whipple’s disease by Polymerase Chain Reaction. Ann Intern Med 1997, 126:520–527. In this important study, PCR-based testing was shown to be superior to histology in diagnosing suspected cases. The PCR test was shown to be superior to histology in follow-up of posttreatment patients. In addition, eradication of T. whippelii after treatment with antibiotics was associated with low risk of relapse, thus emphasizing the importance of monitoring with PCR testing in certain cases.PubMedGoogle Scholar
- 8.Relman DA, Schmidt TM, MacDermott RP, Falkow S: Identification of the uncultured bacillus of Whipple’s disease. N Engl J Med 1992, 327:293–301. This is the first paper to publish the full genetic sequence of the 16S rRNA gene for the Whipple’s-associated bacillus, and to coin the name Tropheryma whippelii for this organism.PubMedCrossRefGoogle Scholar
- 10.Fleming JL, Wiesner RH: Whipple’s disease: clinical, biochemical, and histopathologic features and assessment of treatment in 29 patients. Mayo Clin Proc 1988, 63:539–551. This is one of the largest retrospective studies of clinical features and treatment outcomes in patients with Whipple’s disease, treated at a large tertiary referral center.PubMedGoogle Scholar
- 13.Keinath RD, Merrell DE, Vlietstra R, Dobbins WO III: Antibiotic treatment and relapse in Whipple’s disease. Long term follow-up of 88 patients. Gastroenterology 1985, 88:1867–1873. This is the largest study that pooled data from previously published studies, and reviewed treatment outcomes of this rare condition.PubMedGoogle Scholar
- 14.Duran DV, Lecomte C, Catherbras P, et al.: Whipple Disease: Clinical review of 52 cases. Medicine 1997, 76(3):170–184. This paper compares the two large studies (References 10 and 13) with data on 52 additional patients diagnosed with Whipple’s disease in France, including treatment outcomes and long-term follow-up.CrossRefGoogle Scholar
- 15.Schneider T, Stallmach A, von Herbay A, et al.: Treatment of refractory Whipple disease with interferongamma. Ann Intern Med 1998, 129(11):875–877. Authors in this interesting case report find benefit from using interferon-gamma in a patient with treatment-refractory Whipple’s disease. Also, PCR testing was shown to be useful in determining duration of treatment.PubMedGoogle Scholar