ABSTRACT
Two cases with typical clinical and histological manifestations of Whipple's disease were reported. Peroral jejunal biopsies were studied in the florid stage and during remission achieved by tetracycline therapy. A complete absence of immunoglobulin-containing cells (Ig-CC) and an increased number of mast cells in the mucosa were established in one of the cases. A 5-fold decrease of the mucosal Ig-CC was found by immunofluorescent morphometry in the second case. An increased Ig-CC number and histological restitution of the mucosa were shown in the first case during remission, whereas histological alterations and decreased Ig-CC number persisted in the second case despite of clinical improvement. The HLA-locus B27 was not available in the reported cases.
Subject(s)
Intestinal Mucosa/pathology , Whipple Disease/diagnosis , Female , Fluorescent Antibody Technique , Humans , Immunoglobulins/metabolism , Jejunum/pathology , Macrophages/ultrastructure , Male , Microvilli/ultrastructure , Middle Aged , Whipple Disease/pathologyABSTRACT
A case with nodular lymphoid hyperplasia of the jejunal mucosa associated with hypo- and dysgammaglobulinemia, increased susceptibility to infections, recurrent giardia invasions, absence of plasma cells in the bone marrow and jejunal mucosal stroma and extremely increased number of mucosal mast cells has been described. The latter was supposed to be an essential morphological feature of the syndrome, that is due to a "secondary" response to repeated giardia invasions in a condition of impaired humoral but presumably normal cellular immune response. Some of the tinctorial properties of intestinal mucosal mast cells were discussed.
