Whipple's disease: a histological, immunocytochemical, and electron microscopic study of the small intestinal epithelium

The Journal of Pathology
N L EctorsG R Vantrappen

Abstract

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.

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Citations

Nov 21, 2000·Postgraduate Medical Journal·R N Ratnaike
Jul 12, 2013·Gastroenterology Research and Practice·Jan BurešIlja Tachecí
Jul 31, 2013·The Journal of Allergy and Clinical Immunology·Harry SokolOlivier Hermine
Nov 30, 2018·Digestive Diseases and Sciences·Jamie Ann ElchertGregory S Cooper
Jan 1, 1997·Scandinavian Journal of Gastroenterology·A von HerbayM Maiwald
Oct 24, 2020·The European Respiratory Journal·Alice CambouliveDavid Montani

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