Which of the following is associated with PAS positive Macrophages
The hallmark of Whipple&;s disease is the histopathological finding of macrophages that are positive on periodic acid-Schiff (PAS) staining. The main histological features are extensive PAS-positive material in the lamina propria, and villous atrophy. Characteristic Histopathological finding in Whipple&;s DIsease Infiltration of Lamina Propria with PAS-positive macrophages that are resistant to Diastase (Granular foamy macrophages stained purple with PAS) Inclusions of T.whipplei bacilli or its paly digested remnants may be observed. T.whipplei is a gram-positive, non-acid-fast periodic acid-Schiff (PAS)-positive bacillus with a characteristic trilamellar plasma membrane surrounded by a cell wall. Bacilli with a characteristic trilamellar membrane/wall is specific for Whipple&;s disease The disease of the T.whipplei bacillus outside of macrophages is a more impoant indicator of active disease than is their presence within the macrophages. Whipple&;s Disease Tropical Sprue Coeliac Disease Malasorption syndrome with systemic features with infections etiology Malabsorption syndrome of infection etiology without systemic features Malabsorption syndrome of non-infectious etiology without systemic features Etiology Etiology Etiology Tropheryma whippelii is a small gram-positive bacillus in the group Actinobacteria Caused by some strains of E.coli Caused by intolerance to &;gliadin&; gluten a protein found in wheat rye, barley Biopsy Biopsy Biopsy Biopsy is Abnormal and specific/diagnostic Lamina Propria is infiltrated with macrophages containing PAS positive glycoproteins and rod shaped bacilli Villous Atrophy Biopsy is abnormal but not specific/diagnostic Shoened, thickened villi increased crypt depth infiltration by mononuclear cells Biopsy is abnormal but not specific/diagnostic Blunting and flattening surface with villi either absent or broad and sho crypts are elongated. Dense infiltration of inflammatory cells in lamina propria 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 + Sulfamethoxazole Etiology is infectious so treatment is with antibiotics (Sulphonamide/Tetracycline) Etiology is not infectious but immune Gluten free diet (no antibiotics) + Glucocoicoids or immunosuppressive agents Ref: Harsh Mohan 7th edition Pgno: 559
Whipple's disease
Tropical sprue
Celiac disease
Crohn's Disease
General pathology