Whipple Disease (Whipple's Disease)

A chronic systemic infection by a gram-positive bacterium, Tropheryma whippelii, mainly affecting the SMALL INTESTINE but also the JOINTS; CARDIOVASCULAR SYSTEM; and the CENTRAL NERVOUS SYSTEM. The disease is characterized by fat deposits in the INTESTINAL MUCOSA and LYMPH NODES, malabsorption, DIARRHEA with fatty stools, MALNUTRITION, and ARTHRITIS.

Also Known As:

Networked: 279 relevant articles (21 outcomes, 11 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Celiac Disease (Celiac Sprue)
2.	Sacroiliitis
3.	Spondylitis
4.	Intestinal Diseases (Diseases, Intestinal)
5.	Hepatitis

Experts

1.	Raoult, Didier: 22 articles (06/2015 - 01/2002)
2.	Fenollar, Florence: 14 articles (05/2012 - 06/2003)
3.	Schneider, Thomas: 8 articles (02/2015 - 11/2002)
4.	Moos, Verena: 7 articles (02/2015 - 06/2009)
5.	Mege, Jean-Louis: 7 articles (01/2014 - 06/2003)
6.	Marth, Thomas: 6 articles (12/2014 - 11/2002)
7.	Lepidi, Hubert: 6 articles (09/2010 - 11/2002)
8.	Kowalczewska, Malgorzata: 5 articles (03/2009 - 06/2006)
9.	Altwegg, M: 5 articles (12/2001 - 02/2000)
10.	Lagier, Jean-Christophe: 4 articles (06/2015 - 01/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Whipple Disease:

1.	Trimethoprim-Sulfamethoxazole Combination (Co-Trimoxazole)FDA LinkGeneric 09/01/2010 - "whipplei susceptibility, that trimethoprim/sulfamethoxazole is not optimal for classic Whipple's disease. " 07/01/2008 - "Trimethoprim-sulfamethoxazole is recommended for treatment of Whipple disease but is associated with treatment failure. " 07/01/2008 - "Acquired resistance to trimethoprim-sulfamethoxazole during Whipple disease and expression of the causative target gene." 10/01/2000 - "We report a case of clinical relapse of Whipple's disease in a man who was on a prolonged therapy with trimethoprim-sulfamethoxazole. " 09/01/2000 - "Whipple's disease: acquired resistance to trimethoprim-sulfamethoxazole."
2.	Ceftriaxone (Ceftriaxon)FDA LinkGeneric 08/01/2011 - "After the detection of Tropheryma whipplei and diagnosis of Whipple's disease the patient received ceftriaxon for a period of two weeks, subsequently cotrimoxazol for one year. " 03/15/1990 - "Oculo-facial-skeletal myorhythmia in Whipple disease: treatment with ceftriaxone." 03/01/2013 - "This study indicates that ceftriaxone followed by three months of trimethoprim-sulfamethoxazole is highly efficacious in the treatment of Whipple's disease." 02/01/2010 - "Efficacy of ceftriaxone or meropenem as initial therapies in Whipple's disease." 03/01/2013 - "Intravenous ceftriaxone, followed by 12 or three months of oral treatment with trimethoprim-sulfamethoxazole in Whipple's disease."
3.	Anti-Bacterial Agents (Antibiotics)IBA 12/01/2008 - "Following treatment for three months with antibiotics a significant reduction of the changes typical of Whipple's disease was found upon follow-up biopsy, hence we assume the applied therapy was successful. " 11/25/2000 - "Whipple's disease was diagnosed on the basis of extraintestinal tissue histology (lymph node, vertebral body) and by polymerase chain reaction, and was treated successfully with antibiotics. " 09/01/1996 - "Extraintestinal Whipple's disease (lymph node localisation) was diagnosed in another patient treated successfully with antibiotics. " 01/01/1988 - "This report describes an immunological study made on a 58 years old patient with a Whipple disease diagnosed in 1969 and treated with different antibiotics. " 09/01/2007 - "Whipple's disease was first described in 1907, the genomic composition of the causative organism, Tropheryma whipplei, was unravelled in 2003 and its in vitro susceptibility to antibiotics started to be explored in 2004-05. "
4.	Tetracycline (Achromycin)FDA LinkGeneric 06/15/1988 - "Thus, tetracycline appears to be effective in the treatment of Whipple's disease if given for at least 2 years. " 04/01/1984 - "There is increasing recognition of progressive neurologic disease in patients with Whipple's disease who were treated with tetracycline. " 12/01/1980 - "Transient unilateral sacroiliitis was documented by QSS in a patient with Whipple's disease during tetracycline treatment, when the peripheral arthropathy was in remission. " 08/01/1980 - "She responded well to tetracycline therapy, but succumbed to fatal hepatitis ten weeks after the diagnosis of Whipple's disease" 10/01/1990 - "The authors report the case of a 61 year-old patient treated by tetracycline for very probable Whipple's disease who developed constrictive pericarditis requiring pericardectomy. "
5.	Ampicillin (Omnipen)FDA LinkGeneric 06/01/1966 - "Whipple's disease with clinical remission induced by ampicillin." 10/01/1964 - "REMISSION IN WHIPPLE'S DISEASE INDUCED WITH AMPICILLIN." 06/11/1993 - "Antibiotic treatment with Ampicillin (2 g three times daily) and ceftriaxone (2 g once daily) i.v. for 21 days, followed by oral ofloxacin (200 mg daily) and co-trimoxazole (three times daily 800 mg sulfamethoxazole and 160 mg trimethoprim), brought about remission of Whipple's disease. "
6.	HLA-B27 Antigen (HLA B27 Antigen)IBA 12/01/2008 - "HLA-B27 antigen, which is frequent among those with Whipple's disease, was also present. " 06/01/2001 - "Lack of association with spondyloarthritis and HLA-B27 in Italian patients with Whipple's disease." 08/01/1991 - "Our data suggest that there is no conclusive proof of an association between HLA-B27 and Whipple's disease." 12/01/1985 - "This case supports the hypothesis that Whipple's disease is a disorder related to HLA-B27." 12/01/1985 - "Whipple's disease in an HLA-B27 positive female."
7.	Trimethoprim (Proloprim)FDA LinkGeneric 01/01/2008 - "The combination of trimethoprim and sulphamethoxazole does not prevent or cure involvement of the central nervous system in all patients with Whipple's disease. " 04/01/1981 - "Sulfamethoxazole-trimethoprim may be the treatment of choice for Whipple's disease." 04/01/1981 - "Whipple's disease, successful response to sulfamethoxazole-trimethoprim." 09/01/1996 - "Since five of 12 patients (40%) treated with co-trimoxazole (trimethoprim plus sulphamethoxazole) did not respond, we conclude that the combination of trimethoprim and sulphamethoxazole does not prevent or cure central nervous system (CNS) involvement in all patients with Whipple's disease. " 04/01/1981 - "Because of allergy to penicillin and intolerance to tetracycline, a 47-year old man, known to have Whipple's disease, was treated with sulfamethoxazole-trimethoprim, one tablet two times a day for six months. "
8.	SulfamethoxazoleFDA LinkGeneric 01/01/2008 - "The combination of trimethoprim and sulphamethoxazole does not prevent or cure involvement of the central nervous system in all patients with Whipple's disease. " 04/01/1981 - "Sulfamethoxazole-trimethoprim may be the treatment of choice for Whipple's disease." 04/01/1981 - "Whipple's disease, successful response to sulfamethoxazole-trimethoprim." 09/01/1996 - "Since five of 12 patients (40%) treated with co-trimoxazole (trimethoprim plus sulphamethoxazole) did not respond, we conclude that the combination of trimethoprim and sulphamethoxazole does not prevent or cure central nervous system (CNS) involvement in all patients with Whipple's disease. " 04/01/1981 - "Because of allergy to penicillin and intolerance to tetracycline, a 47-year old man, known to have Whipple's disease, was treated with sulfamethoxazole-trimethoprim, one tablet two times a day for six months. "
9.	Penicillins (Penicillin)FDA Link 11/01/1980 - "Penicillin may suppress, but not prevent, central nervous system disease in patients with otherwise successfully treated Whipple's disease." 11/01/1980 - "A man with Whipple's disease was treated with oral penicillin (500 mg twice a day) for 2 years with eradication of bacillary organisms from the jejunum and a return of jejunal histologic findings to normal. " 06/01/1985 - "It is concluded that tetracycline alone, or penicillin alone, is not adequate initial therapy for Whipple's disease and that central nervous system relapse is resistant to antibiotic therapy. " 06/01/1985 - "The authors recommend parenteral penicillin and streptomycin followed by 1 yr of oral trimethoprim-sulfamethoxazole therapy or oral trimethoprim-sulfamethoxazole alone for 1 yr as initial therapy for Whipple's disease. " 09/01/1996 - "Third generation cephalosporins have been shown to be beneficial in cerebral Whipple's disease, therefore initial antibiotic treatment of Whipple's disease should consist of ceftriaxone (instead of penicillin) combined with streptomycin. "
10.	Immunoglobulins (Immunoglobulin)IBA 11/01/2010 - "Thus, we were able to demonstrate that general mucosal immunoglobulin production in Whipple's disease patients is impaired. " 11/01/2010 - "Mucosal immunoglobulins are essential for the defense against intestinal pathogens; therefore, we analyzed the B-cell response in duodenal specimens and sera of Whipple's disease patients. " 09/01/2009 - "Total immunoglobulin from patients with classic Whipple disease exhibited either a lack of reaction (23 [38%] of 60 patients) or a decrease in reaction (33 [55%] of 60 patients) with a T. " 11/01/2010 - "Whereas systemic immunoglobulin production was affected only marginally, duodenal biopsy specimens of Whipple's disease patients contained reduced numbers of immunoglobulin-positive plasma cells and secreted less immunoglobulin compared to healthy controls but showed a weak secretory IgA response toward T. " 01/01/1981 - "Patients with Whipple's disease do not have a disorder of immunoglobulin synthesis and do not have immune complexes present in their gut walls. "

Therapies and Procedures

1.	Aftercare (After-Treatment) 05/01/1985 - "A patient with Whipple's disease was considered as cured after treatment for two years, but relapse occurred as the neurological form. " 03/01/1997 - "Comparison of histology with PCR in mucosal samples of patients with Whipple's disease before, during, and after treatment. " 02/29/1964 - "[CLINICAL, HISTOLOGIC AND ULTRAMICROSCOPIC STUDY OF A CASE OF WHIPPLE'S DISEASE, BEFORE AND AFTER TREATMENT WITH AUREOMYCIN]." 09/01/2010 - "Failure and relapse after treatment with trimethoprim/sulfamethoxazole in classic Whipple's disease." 01/01/2015 - "Whipple's disease should be suspected in all patients diagnosed with chronic inflammatory rheumatism, partially controlled or not controlled by treatment with tumor necrosis factor alpha blockers, whose condition worsens after treatment."
2.	Laparotomy 05/01/2014 - "After laparotomy, biopsy and histochemical study of the lesions with negative results for malignancy, we proceeded to the investigation of Whipple's disease, which was then confirmed. " 09/01/1996 - "A third case of Whipple's disease was unexpectedly diagnosed by laparotomy and partial small bowel resection. " 06/01/1982 - "At laparotomy, an edematous, thickened mid-portion of small bowel matted between large lymph nodes, involved by characteristics of Whipple's disease, seemed to be responsible for the small-bowel obstruction." 08/01/1980 - "Whipple's disease was diagnosed in a 42-year-old woman by the histological examination of a mesenteric lymph node taken at laparotomy, and the electron microscopic examination of a peroral intestinal biopsy specimen. "
3.	Jejunoileal Bypass 02/01/1996 - "Human models: Whipple's disease, coeliac disease and jejunoileal bypass." 06/01/2009 - "Diseases leading to inflammatory joint involvement such as inflammatory bowel disease, Whipple's disease or surgical intestinal bypass, are classified as enteropathic arthritis. " 08/01/2003 - "Joint involvement also occurs with other gastrointestinal diseases such as Whipple's disease, celiac disease, and following intestinal bypass surgery for morbid obesity. " 01/01/1992 - "2. Whipple's disease, enteric infections, intestinal bypass operations, gluten-sensitive enteropathy, pseudomembranous colitis and collagenous colitis." 01/01/1987 - "Musculoskeletal disease occurs in association with inflammatory bowel disorders including Crohn's disease and ulcerative colitis, as well as with Whipple's disease; with enteritis caused by Salmonella, Shigella, and Yersinia; and also following intestinal bypass surgery. "
4.	Pericardiectomy 01/01/2013 - "The optimal approach to managing constrictive pericarditis in patients with Whipple's disease is uncertain, but limited clinical experience suggests that a combination of pericardiectomy and antibiotic therapy is of benefit." 10/01/1990 - "The authors report the case of a 61 year-old patient treated by tetracycline for very probable Whipple's disease who developed constrictive pericarditis requiring pericardectomy. "
5.	Lasers (Laser) 01/01/2010 - "In vivo identification by confocal laser endoscopy of foamy macrophages associated with Whipple's disease." 04/15/2001 - "Tissue sections from 8 patients with Whipple's disease and from 19 healthy control subjects were analyzed by use of fluorescence in situ hybridization and laser scanning confocal microscopy, to determine the location of rRNA that would indicate the presence of metabolically active bacteria. "