Abstract
A patient with Whipple's disease is described, in whom a clinical remission began shortly after the initiation of chloramphenicol therapy. In tests with intravenously administered I 181-labeled polyvinylpyrrolidone, the patient was found to have a mild degree of “protein-losing gastroenteropathy.” Routine microscopic sections of a biopsy specimen of duodenum demonstrated the characteristic features of Whipple's disease: widened and shortened villi, dilated lacteals, and sheets of large, PAS-positive, “foamy” cells in the lamina propria. Histochemical reactions demonstrated the presence and localization in the intestinal mucosa of various enzymes representative of the glycolytic and tricarboxylic acid pathways both in a patient with Whipple's disease and in a normal control subject. Electron micrographs also showed minute cylindrical bodies, both intracellular and extracellular in location. Larger areas appearing as a lacy reticulum were present and probably represented secretions corresponding to the PAS-positive material elaborated by the “foamy” mononuclear cells.
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