[Weight loss, renal insufficiency, aortal stenosis and arthralgias]

The 68-year-old male patient complained of weight loss and -- since 15 years -- of arthralgias and had renal insufficiency and an aortic stenosis. Despite the lack of intestinal symptoms, M. Whipple could be diagnosed, being responsible for his symptoms and clinical signs. Under antibiotic and supportive treatment the patient recovered uneventfully.Whipple's disease, otherwise known as intestinal lipodystrophy, is a disease with various signs and symptoms. The principal signs are rheumatic complaints and weight loss. By contrast, there may be absolutely no gastrointestinal symptoms even at an advanced stage of the disease. The generally chronic clinical course of the disease may worsen acutely and may prove fatal. Symptoms frequently occur not simultaneously but successively. Diagnostically, it is crucial to consider the possibility of infection with Tropheryma whippelii primarily if the patient presents with multi-organ symptoms. The disease is easy to diagnose by taking bioptic samples endoscopically -- even in the absence of intestinal symptoms -- and antibiotic treatment is generally successful. However, permanent organic lesions must be anticipated.