Whipple's disease: A review

The literature pertaining to Whipple Disease is expanding at an increasing rate as advances in basic science are made and applied clinically. From the first ill-understood but captivating case report, we have progressed to understand more fully the role of bacteria in the disease and to establish effective although empiric treatment regimens. Whether the disease is caused by a unique bacterium capable of intracellular survival and replication or a common organism in a host with impaired immunity, or even multiple organisms effecting a common host response remains to established. The difficulty in isolating and culturing the organism as well as the reversibility of most of the immunological abnormalities favors the former hypothesis. Host defenses may, however, still play an important role. In the future, characterization and culture of the etiological agent will hopefully be achieved. This coupled with the advances in immunology will allow for a more complete understanding of the pathogenesis of the disease and possibly specific modalities of therapy.