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- Title
Lymphedema, lymphocytic myocarditis, and sarcoidlike granulomatosis. Manifestations of Whipple's disease.
- Authors
Southern, J F; Moscicki, R A; Magro, C; Dickersin, G R; Fallon, J T; Bloch, K J
- Abstract
A patient with Whipple's disease presented with a long prodromal period characterized by granulomatous lymphadenitis and progressive lymphedema of the extremities. No gastrointestinal tract symptoms were present and a small bowel biopsy sample was normal. His clinical condition deteriorated with the onset of lymphocytic myocarditis. At autopsy, intestinal involvement with macrophages that stained positively with periodic acid-Schiff was limited primarily to the submucosa. Diffuse fibrous effacement of lymph nodes with afferent lymphangiectasia seemed to be the mechanism of diffuse lymphedema, protein-losing enteropathy, and hypoproteinemia. Whipple's disease, therefore, should be considered in the differential diagnosis of patients presenting with granulomatous disease, lymphocytic myocarditis, or unusual lymphedema.
- Publication
JAMA: Journal of the American Medical Association, 1989, Vol 261, Issue 10, p1467
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.261.10.1467