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.
(see: Other disease ).

In brief, the symptoms of Whipple´s disease are typically heterogeneous.

References:

1a. Sieracki (1958; 1959) Sieracki JC (1958). Whipple´s disease - observations on systemic involvement.
      I. Cytologic observations. Arch Pathol 66:464-467
1b. Sieracki JC, Fine G (1959). Whipple´s disease - observations on systemic involvement.
      II. Gross and histologic observations. Arch Pathol 67:81-93
1c. Sieracki JC, Fine G, Horn RC (1960). Central nervous system involvement in Whipple´s disease.
      J Neuropathol Exp Neurol 19:70-75
2.  Enzinger FM, Helwig EB (1963). Whipple´s disease. A review of the literature and report of 15 patients.
     Virchows Archiv 336:238-269
3.  Maizel H, Ruffin JM, Dobbins WO III (1970). Whipple´s disease: a review of 19 patients from one hospital and
     review of the literature since 1950. Medicine 49:175-205
4.  von Herbay A, Otto HF (1988). Whipple´s disease. A report of 22 patients. Klin Wochenschr 66: 533-539
5.  Fleming JL, Wiesner RH, Shorter RG (1988). Whipple´s disease: clinical, biochemical, and histopathologic 
     features and assessment of treatment in 29 patients. Mayo Clin Proc 63:539-551
6.  Vital-Durand D, Lecomte C, Cathebras P, et al.  (1997) Whipple´s disease: clinical review of 52 cases.
     Medicine 76: 170-184