Whipple's disease in children: symptoms, causes, diagnosis, treatment, complications, prognosis

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The disease is very rare: it occurs in one person per million. Men get sick more often than female representatives eight times. The age when the pathology is usually found is about fifty years.

The disease is expressed in the bacterial lesion of the small intestine, which can create conditions in the body for the functional discomfort of a number of body systems. It is necessary at the first suspicion of regular indispositions immediately to consult a doctor for advice.

Symptoms of Whipple's disease

Symptoms of the disease can be very diverse. The first symptoms do not indicate problems of the gastrointestinal tract. Calls about this appear later, sometimes in a few years.

The main attributes include:

  • chronic fever,
  • joint disease:
    • pain in them, changing dislocation( in one joint pain, then in another);
    • swelling and swelling of the joints;
  • lesions of the lymph nodes,
  • chronic pain in the muscles and the appearance of seals in them,
  • chest pain,
  • moist cough.
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After some time, sometimes two years, and sometimes much more, disorders of the digestive organs become noticeable:

  • diarrhea - frequent urges, foamy stools;
  • patient noticeably thins worse,
  • nausea,
  • lack of appetite,
  • impotence,
  • cramping pain( localization near navel),
  • signs of avitaminosis,
  • bloating,
  • pigmentation and skin peeling.

Further development of the disease causes system disruptions:

  • neurological disorders,
  • tracheobronchitis,
  • heart diseases associated with the defeat of its various components:
    • shells,
    • valves,
    • muscle;
  • eye diseases
  • and others.

Forms of

Specialists share the course of the disease in three periods, which flow, as a result of the progression of pathology, into each other, adding new symptoms.

  1. At the first stage of , disorders occur that do not have symptoms of digestive tract problems. This period is called the stage of extraintestinal manifestations.
  2. The second stage of is associated with impaired absorption of nutrients by the wall of the small intestine, so discordances in the area of ​​the gastrointestinal tract become apparent. This period is called the intestinal stage.
  3. The last stage of the disease , when already indicated failures in the operation of systems, is called the stage of polyorganism disorders.

Reasons for

Why there is a disease - the experts this issue has caused a lot of controversy. To date, it is commonly believed that the cause of the pathology is the bacterium Tropheryma whippelii.

This is facilitated by such circumstances:

  • malnutrition,
  • immunity, weakened by negative influences on the body( bad ecology, diseases, hunger),
  • genetic predisposition.

Diagnosis

To determine the disease is problematic, because the symptomatology can be very different, and at the first stage, violations in the area of ​​the gastrointestinal tract are not indicated. Therefore, in order to correctly diagnose, it is necessary to conduct a whole complex of diagnostic actions.

  • The attending physician analyzes the patient's complaints, what symptoms the problem is and how long they have appeared.
  • Consider close relatives. The specialist is interested in what the relatives suffer, whether they have diseases typical of Whipple's disease:
    • celiac disease - the small intestine can not absorb the protein component of cereals,
    • stomach ulcer - violation of the integrity of the walls of the organ of varying complexity,
    • malabsorption - impaired ability to metabolize vitamins andnutrients in the walls of the small intestine,
    • Crohn's disease - the small intestine is affected by inflammatory processes of severe form.
  • A complete picture of the patient's illness is compiled. Special attention is paid to the presence in the patient of chronic diseases of the gastrointestinal tract:
    • cholecystitis,
    • pancreatitis,
    • cholelithiasis
    • and others.
  • The patient is examined for the possibility of parasites present in the body. This circumstance contributes to a decrease in immunity, which in turn helps to attach a bacterial infection.
  • Laboratory tests:
    • Coprogram - to confirm the diagnosis it will be important to know whether there is presence in the stool:
      • fat in large quantities,
      • dietary fiber,
      • food fragments that have remained undigested.
    • Clinical blood test - the study will show whether the baseline blood counts are normal, it is especially important to know what level of hemoglobin.
    • Polymerase Chain Reaction-The assay is capable of detecting the presence of Tropheryma whippelii( a DNA pathogen) in the contents of the gastrointestinal tract or in saliva.
    • Biochemical blood test - the study provides an opportunity to determine whether there are functional disorders of internal organs.
  • Diagnostic measures with the help of equipment:
    • Computed tomography allows you to obtain information about the condition of internal organs.
    • Endoscopy of the intestine - experts examine the organ and using biopsy( separation of a small portion of the intestinal mucosa) and histological examination of the extracted biomaterial, information on the state of the walls of the small intestine is obtained.
    • Echocardiography is a study of the heart to find out whether pathological changes in the heart are characteristic of Whipple's disease.
    • Ultrasound examination of internal organs and lymph nodes for obtaining detailed information on their condition.

Treatment

When a diagnosis is made, a comprehensive treatment is prescribed. The disease requires patience from the patient and the doctor. The treatment process lasts at least a year.

The complex of measures includes:

  • Drugs:
    • hormones( if the doctor finds it necessary),
    • antimicrobial drugs( co-trimoxazole),
    • antibiotics( tetracyclines well suited, there may be other drugs such as penicillins),
    • minerals and vitamins.
  • Compliance with diet number 5. Food should be light, high protein. The quantity and range of fatty foods is significantly limited.

Complications of

If a person does not pay attention to an ailment and does not receive medical care, then the disease progresses. As a result, there may be consequences that can threaten the life of the patient.

This:

  • adrenal gland disorders,
  • endocarditis - inner wall,
  • anemia,
  • pericarditis - fluid accumulation in the pericardial cavity,
  • cachexia - body exhaustion to a large extent,
  • myocarditis - cardiac muscle pathology,
  • insufficient functioning of several systemsorganism - multi organ dysfunction,
  • accumulation of excess fluid in the brain area( edema),
  • relapse of the disease.

Forecast

If the patient is on time treatment, then the prognosis is usually favorable. What will be the result after a long time from the onset of the disease, depends on such circumstances:

  • how timely the patient came to specialists for help,
  • whether there were irreversible phenomena in the body, how many systems and to what extent they began to work with the deterioration of functions.

Prevention

Specialists give advice on how to avoid relapse of the disease.

  • It is necessary to strictly follow the advice of doctors, carefully follow the treatment regimens.
  • You should stick to the diet.
  • It is mandatory to undergo regular diagnostic procedures appointed by specialists.
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