Whipple’s disease—historical insights and contemporary perspectives

Abstract

Whipple’s disease is a rare infectious illness caused by the bacterium Tropheryma whipplei. It can be a challenging condition to diagnose and treat. Whipple’s disease was first recognized and described over 100 years ago, but for many decades there was little insight or knowledge of the pathophysiological basis of the disease. Recent scientific developments have helped improve understanding of the disease process. The condition follows a slowly progressive course, and characteristically presents with a combination of weight loss, chronic diarrhoea, arthralgia and abdominal pain. Although often thought of as a gastrointestinal disease, it is in fact a systemic illness and multi-organ involvement is usually present. With appropriate antibiotic treatment the disease can potentially be cured, but prior to the advent of antibiotics the condition was invariably fatal. In this article, Jonathan Macdonald and John S Leeds highlight the important historical milestones in the understanding of this disease, and provide an overview of the key aspects of the pathogenesis, diagnosis, and treatment of this condition.