Initially considered to be an intestinal disorder, Whipple´s disease is in fact a multisystem disease. ( 1) Virtually any organ may
be infected byTropheryma whippelii. As a consequence, symptoms may arise from many organs.
Previous editions of textbook articles described an allegedly typical patient to suffer from arthralgias,
diarrhea and weight loss. These features were fairly common at a time when the diagnosis was not reached until autopsy, and no antibiotic treatment was given. ( 2, 3 )
With the advent of endoscopy and the
availability of antibiotics, the features at clinical presentation have remarkebly changed. Nowadays approximately two thirds of patients present with arthralgias, diarrhea, and weight loss. At least one third present
with a plethora of other symptoms. They include: dementia, gaze palsy, peripheral lymphadenopahy, cardiac insufficiency, pleural effusion, skin hyperpigmentation, anaemia, fever. ( 4, 5, 6 )
With the availability of
DNA assays, the spectrum seemed to broaden further. There are some observations of patients with various extra-intestinal of T. whippelii infection, but without intestinal Whipple´s disease. Other disease ).
In brief, the symptoms of Whipple´s disease are typically heterogeneous.