Whipple’s disease Clinical Gastroenterology and Hepatology

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Presentation transcript:

Whipple’s disease Clinical Gastroenterology and Hepatology Julio C. Bai, Roberto M. Mazure, Horacio Vazquez, Sonia I. Niveloni, Edgardo Smecuol, Silvia Pedreira, Eduardo Mauriño Clinical Gastroenterology and Hepatology Volume 2, Issue 10, Pages 849-860 (October 2004) DOI: 10.1016/S1542-3565(04)00387-8 Copyright © 2004 American Gastroenterological Association Terms and Conditions

Figure 1 Small bowel follow-through in a patient with active WD showing thickened folds in the jejunum (Kerckring’s folds). Some folds show a nodular tip as shown by the arrow. These characteristics are produced by the macrophage infiltration of the lamina propria, lymphangiectasias, and edema. Clinical Gastroenterology and Hepatology 2004 2, 849-860DOI: (10.1016/S1542-3565(04)00387-8) Copyright © 2004 American Gastroenterological Association Terms and Conditions

Figure 2 Characteristic endoscopic findings in the distal duodenum showing thick intestinal folds with multiple whitish-yellow small plaques diffusely distributed in the intestinal mucosa. Clinical Gastroenterology and Hepatology 2004 2, 849-860DOI: (10.1016/S1542-3565(04)00387-8) Copyright © 2004 American Gastroenterological Association Terms and Conditions

Figure 3 PAS-positive staining of a duodenal biopsy showing part of a villous structure exhibiting the lamina propria infiltrated by macrophages (histiocytes) filled with PAS-positive inclusions from a patient with WD. The intestinal epithelium shows as preserved. Original magnification 1000×. Clinical Gastroenterology and Hepatology 2004 2, 849-860DOI: (10.1016/S1542-3565(04)00387-8) Copyright © 2004 American Gastroenterological Association Terms and Conditions

Figure 4 Electron micrograph of a tissue sample (duodenal biopsy) of a patient with untreated WD illustrating a macrophage showing the characteristic trilamellar wall appearance of T. whippeli. Clinical Gastroenterology and Hepatology 2004 2, 849-860DOI: (10.1016/S1542-3565(04)00387-8) Copyright © 2004 American Gastroenterological Association Terms and Conditions