Whipple's disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
Tropheryma whipplei infection has different clinical manifestation and natural history. It could cause acute infection, localized infection and the classic Whipple's disease. Each of these manifestations has its own progression.
Acute infection
- Tropheryma whipplei causes acute infections, including:[1]
- Gastroenteritis: Patients have watery diarrhea and colicky abdominal pain.
- Pneumonia
- Bacteremia
Classic Whipple's disease
Patients who developed the classic Whipple's disease have different natural history
- Patient with classic Whipple's disease in the early phase has nonspecific symptoms including fever and arthralgia that could last for years.[2]
- In the middle phase, patients develop gastrointestinal symptoms including diarrhea, abdominal pain and weight loss.[3]
- In the late phase, other organs might be involved. Neurologic symptoms including progressive dementia, personality changes and seizures might happen. Eyes, heart, lung, liver, and skin can be involved in this phase.[4]
Localized infection
Complications
- Common complications of Whipple's disease include:
- Cardiac complications
- Adhesive pericarditis
- Myocardial fibrosis
- Neurologic complications
- Progressive dementia
- Cerebellar ataxia
- Personality changes
- Hemiparesis
- Seizure
- Wernicke’s encephalopathy
- Hypothalamic involvement
- Supranuclear ophthalmoplegia
- Cardiac complications
Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
References
- ↑ Raoult, Didier; Fenollar, Florence; Rolain, Jean-Marc; Minodier, Philippe; Bosdure, Emmanuelle; Li, Wenjun; Garnier, Jean-Marc; Richet, Hervé (2010). "Tropheryma whipplei in Children with Gastroenteritis". Emerging Infectious Diseases. 16 (5): 776–782. doi:10.3201/eid1605.091801. ISSN 1080-6040.
- ↑ Bai, J; Mazure, R; Vazquez, H; Niveloni, S; Smecuol, E; Pedreira, S; Maurino, E (2004). "Whipple's disease". Clinical Gastroenterology and Hepatology. 2 (10): 849–860. doi:10.1016/S1542-3565(04)00387-8. ISSN 1542-3565.
- ↑ Puéchal, Xavier (2013). "Whipple's disease". Annals of the Rheumatic Diseases. 72 (6): 797–803. doi:10.1136/annrheumdis-2012-202684. ISSN 0003-4967.
- ↑ Fleming, Jon L.; Wiesner, Russell H.; Shorter, Roy G. (1988). "Whipple's Disease: Clinical, Biochemical, and Histopathologic Features and Assessment of Treatment in 29 Patients". Mayo Clinic Proceedings. 63 (6): 539–551. doi:10.1016/S0025-6196(12)64884-8. ISSN 0025-6196.