Macrophages containing large quantities of undigested and paial digested bacteria in intestine are seen in
Answer is A (Whipple's Disease): The hallmark of Whipple's disease is a small intestinal mucosa laden with distended macrophages in the lamina propria- the macrophages contain p eriodic acid-schiff (PAS) positive granules and rod shaped bacilli by electron microscopy. Three most commonly asked forms of Malabsorption Syndromes : Whipple's Disease Tropical Sprue Coeliac Disease Malabsorption syndriome with systemic Malabsorption syndrome of infectious Malabsorption syndrome of non infectious features with infectious etiology etiology without systemic features etiology without systemic features Etiology Etiology Etiology Gram negative actinomycete Tropheryma whippelii Caused by some strains of E.coli Caused by intolerance to `gliadin. gluten a protein found in wheat rye, barleyQ. Biopsy Biopsy Biopsy Diagnostic Abnormal but Not Diagnostic Abnormal / Characteristic but Not Diagnostic Lamina Propria is infiltrate with of macrophages containing PAS positive glycoproteins and rod shaped bacilli Dilated lymphatic Shoened, thickened villi increased crypt depth infiltration by mononuclear cells Blunting and flattening surface with villi either absent or broad and sho Crypts are elongated Dense infiltration of inflammatory cells in lamina propria inflammatory Clinical features Clinical features Clinical features Features of malabsorption + Array of systemic features Features of malabsorption Features of malabsorption Management Management Management Etiology is infectious so treatment is with Antibiotics Trimethoprim+sufamethoxocate Etiology is infectious so treatment is with antibiotics Antibiotic (Sulfonamide/ Tetracycline) Etiology is not infectious but immune Glutin free diet (no antibiotics) + Glucocoicoids or immunosuppressive agents
Whipple's disease
Amyloidosis
Immunoapproliferative small instetinal disease
Vibro cholerae infection