Epidemiology of Whipple's disease in Germany - Analysis of 110 patients diagnosed in 1965-95

Background: The epidemiology of Whipple's disease (WD) is obscure. To obtain basic data, we performed an evaluation of WD patients in Germany. Methods: Information was collected from 110 WD patients diagnosed during 1965-95 at 5 institutions in different regions of Germany. Four items were evaluated: 1) year in which the diagnosis was made; 2) residence and 3) age at the time of diagnosis; and 4) sex. Results: WD patients originated from all parts of Germany. The incidence of new cases was relatively stable, with a mean of one to two cases per year per collecting centre. In 1995, a maximum of 13 new WD patients was diagnosed. There was a significant increase in the mean age of patients (1965-75, 48.7 years; confidence interval, +/-3.98 years; 1976-85, 50.7 years, +/-3.69 years; 1986-95, 57.0: years, +/-2.80 years; P < 0.01) and an increasing proportion of women (1965-85, 4%; 1986-1995, 22%). Conclusions: Whipple's disease is not quite as rare as commonly assumed. There is no obvious geographic predominance. During the past three decades, the demography of WD patients has changed.