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Whipple's disease: A histological, immunocytochemical, and electron microscopic study of the small intestinal epithelium
Author(s) -
Ectors Nadine L.,
Geboes Karel J.,
de Vos Rita M.,
Heidbuchel Hein P.,
Rutgeerts Paul J.,
Desmet Valeer J.,
Vantrappen Gaston R.
Publication year - 1994
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.1711720112
Subject(s) - pathology , epithelium , intestinal epithelium , immunocytochemistry , electron microscope , biology , medicine , physics , optics
At endoscopy, the duodenum in Whipple's disease frequently appears abnormal and some clinical features such as gastrointestinal blood loss and anaemia suggest epithelial damage. However, the intestinal epithelial cells themselves appear to be normal on light and electron microscopy. The aims of this study were to analyse in detail the cytological changes in epithelial cells over time and in response to therapy in biopsies obtained from 20 patients, to investigate the functional repercussion on digestive enzymes such as lactase, and to assess the expression by the epithelial cells of MHC antigens. Cytological changes were minimal at both the light‐ and the electron‐microscopic level and MHC class I expression was preserved. However, changes indicative of functional deficits were demonstrated. Lactase and MHC class II expression were reduced or even absent. Antibiotic therapy resulted in normalization within 3–6 months. These findings are consistent with the clinical evolution and are of interest with regard to the importance of the immune response in aetiopathogenesis.