Title | Lymphedema, lymphocytic myocarditis, and sarcoidlike granulomatosis. Manifestations of Whipple's disease. |
Publication Type | Journal Article |
Year of Publication | 1989 |
Authors | Southern JF, Moscicki RA, Magro C, Dickersin GR, Fallon JT, Bloch KJ |
Journal | JAMA |
Volume | 261 |
Issue | 10 |
Pagination | 1467-70 |
Date Published | 1989 Mar 10 |
ISSN | 0098-7484 |
Keywords | Adult, Diagnosis, Differential, Granuloma, Humans, Intestine, Small, Lymph Nodes, Lymphedema, Macrophages, Male, Myocarditis, Myocardium, Prednisone, Sarcoidosis, Whipple Disease |
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. |
Alternate Journal | JAMA |
PubMed ID | 2465422 |
Related Faculty:
Cynthia M. Magro, M.D.