Periodic Acid Schiff (PAS)-Positive macrophages deposited in Lamina prior of Gastrointestinal tract with history of abdominal pain, & diarrhea occur occasionally. The diagnosis is
(C) Whipples diseaseoTraditional laboratory diagnosis is based on light microscopy, which shows diastase- resistant, Periodic Acid-Schiff (PAS)-positive, non-acid-fast granules in macrophages The distinction could be made by acid-fast staining, which is positive for patients infected with M. avium and negative for those with Whipple's disease.[?]Whipple's Disease: This rare condition is characterized by infiltration of small intestinal mucosa by 'foamy macrophages, which stain positive with periodic acid-Schiff (PAS) reagent.oCaused by infection with the Gram Positive Bacillus Tropheryma whipplei.oThe disease is a multisystem.oLab abnormalities:-Anemia, hypoalbuminemia, low serum carotene & iron.-Increased stool fat.oBiopsy: Villi become distended with foamy & PAS + macrophages.-Rod-shaped free bacilli in the lamina propria.oPCR of tissue or blood.CLINICAL FEATURES OF WHIPPLE'S DISEASEGastrointestinal (>70%)*. Diarrhoea (75%)*. Steatorrhoea*. Weight loss (90%)*. Protein losing enteropathy*. Ascites*. Hepato-splenomegaly (<5%)Musculoskeletal (65%)* Seronegative large joint arthropathy* SacroilitisCardiac (10%) * Pericarditis, Myocarditis* Endocarditis, Coronary arteritisNeurological (10-40%) *. Apathy, Fits*. Dementia*. Myoclonus, Meningitis*. Cranial nerve lesionsPulmonary (10-20%)*. Chronic cough, Pleurisy*. Pulmonary infiltratesHaematological (60%)^#*. Anaemia, Other (40%)*. Fever*. Lymphadenopathy*. Pigmentation
Giardiasis
Crohn's disease
Whipple's disease
Amoebiasis
G.I.T.