一种由革兰阳性菌Tropheryma whipplei引起的累及多系统慢性疾病，由 G.H.Whipple 于 1907 年首次描述。
阅读更多受感染的患者通常为中年白人男性，可能出现体重减轻、关节痛、腹泻和发热等症状。
虽然T whipplei广泛存在于环境中，但是该病感染几率很低，估计发病率＜1/1,000,000。
主要根据十二指肠活检结果进行诊断。组织学检查特点是，黏膜固有层出现泡沫样巨噬细胞，其细胞质中含有大量抗淀粉酶的过碘酸-希夫 (PAS) 阳性微粒。根据脑脊液 (CSF) 或滑液的聚合酶链反应 (PCR) 检查结果可确诊。
建议采用静脉注射头孢曲松 14 天，然后改为口服甲氧苄啶/磺胺甲基异恶唑一年进行治疗。
Whipple 病是一种罕见的累及多系统、慢性、传染性疾病，其由 G.H.Whipple 于 1907 年首次描述。[1]Whipple GH. A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues. Bull Johns Hopkins Hosp. 1907;18:382-393.Tropheryma whipplei是一种革兰阳性菌，属放线菌进化枝，基因组富含核苷酸鸟嘌呤和胞嘧啶 (G-C)。[2]Raoult D, Ogata H, Audic S, et al. Tropheryma whipplei twist: a human pathogenic Actinobacteria with a reduced genome. Genome Res. 2003;13:1800-1809.http://genome.cshlp.org/content/13/8/1800.longhttp://www.ncbi.nlm.nih.gov/pubmed/12902375?tool=bestpractice.com[3]Bentley SD, Maiwald M, Murphy LD, et al. Sequencing and analysis of the genome of the Whipple's disease bacterium Tropheryma whipplei. Lancet. 2003;361:637-644.http://www.ncbi.nlm.nih.gov/pubmed/12606174?tool=bestpractice.comT whipplei广泛存在于环境中[4]Schoniger-Hekele M, Petermann D, Weber B, et al. Tropheryma whipplei in the environment: survey of sewage plant influxes and sewage plant workers. Appl Environ Microbiol. 2007;73:2033-2035.http://aem.asm.org/cgi/content/full/73/6/2033http://www.ncbi.nlm.nih.gov/pubmed/17277223?tool=bestpractice.com[5]Maiwald M, Schuhmacher F, Ditton HJ, et al. Environmental occurrence of the Whipple's disease bacterium (Tropheryma whippelii). Appl Environ Microbiol. 1998;64:760-762.http://aem.asm.org/cgi/content/full/64/2/760http://www.ncbi.nlm.nih.gov/pubmed/9464419?tool=bestpractice.com以及健康携带者体内。[6]Fenollar F, Trani M, Davoust B, et al. Prevalence of asymptomatic Tropheryma whipplei carriage among humans and nonhuman primates. J Infect Dis. 2008;197:880-887.http://jid.oxfordjournals.org/content/197/6/880.fullhttp://www.ncbi.nlm.nih.gov/pubmed/18419351?tool=bestpractice.com[7]Ehrbar HU, Bauerfeind P, Dutly F, et al. PCR-positive tests for Tropheryma whippelii in patients without Whipple's disease. Lancet. 1999;353:2214.http://www.ncbi.nlm.nih.gov/pubmed/10392994?tool=bestpractice.com[8]Amsler L, Bauernfeind P, Nigg C, et al. Prevalence of Tropheryma whipplei DNA in patients with various gastrointestinal diseases and in healthy controls. Infection. 2003;31:81-85.http://www.ncbi.nlm.nih.gov/pubmed/12682812?tool=bestpractice.com[9]Maibach RC, Dutly F, Altwegg M. Detection of Tropheryma whipplei DNA in feces by PCR using a target capture method. J Clin Microbiol. 2002;40:2466-2471.http://jcm.asm.org/cgi/content/full/40/7/2466http://www.ncbi.nlm.nih.gov/pubmed/12089263?tool=bestpractice.com[10]Zinkernagel AS, Gmur R, Fenner L, et al. Marginal and subgingival plaque: a natural habitat of Tropheryma whipplei? Infection. 2003;31:86-91.http://www.ncbi.nlm.nih.gov/pubmed/12682813?tool=bestpractice.com[11]Rolain JM, Fenollar F, Raoult D. False positive PCR detection of Tropheryma whipplei in the saliva of healthy people. BMC Microbiol. 2007;7:48.http://www.biomedcentral.com/1471-2180/7/48http://www.ncbi.nlm.nih.gov/pubmed/17535423?tool=bestpractice.comWhipple 病的遗传易感性似乎能够确定其感染的可能性。[12]Schneider T, Moos V, Loddenkemper C, et al. Whipple's disease: new aspects of pathogenesis and treatment. Lancet Infect Dis. 2008;8:179-190.http://www.ncbi.nlm.nih.gov/pubmed/18291339?tool=bestpractice.com[13]Fenollar F, Puechal X, Raoult D. Whipple's disease. N Engl J Med. 2007;356:55-66.患者通常为中年白人男性，可能出现关节痛、体重减轻、腹泻和发热等症状。[12]Schneider T, Moos V, Loddenkemper C, et al. Whipple's disease: new aspects of pathogenesis and treatment. Lancet Infect Dis. 2008;8:179-190.http://www.ncbi.nlm.nih.gov/pubmed/18291339?tool=bestpractice.com[13]Fenollar F, Puechal X, Raoult D. Whipple's disease. N Engl J Med. 2007;356:55-66.[14]Dobbins WO 3rd. Is there an immune deficit in Whipple's disease? Dig Dis Sci. 1981;26:247-252.http://www.ncbi.nlm.nih.gov/pubmed/6165533?tool=bestpractice.com[15]Dobbins WO. Whipple's disease. Springfield, IL: Thomas; 1987.
