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January 1950

WHIPPLE'S INTESTINAL LIPODYSTROPHY: Report of Four Cases and Discussion of Possible Pathogenic Factors

Author Affiliations


From the Departments of Medicine, Pathology and Biochemistry, Duke University School of Medicine.

Arch Intern Med (Chic). 1950;85(1):91-131. doi:10.1001/archinte.1950.00230070113006

AMONG debilitating diseases is a rare pathologic state of unknown cause first described in 1907 by Whipple.1 It is characterized clinically by gastrointestinal distress with fatty diarrhea and failure of intestinal absorption leading to death. In some respects it resembles the sprue syndrome, but macrocytic anemia is lacking. In many of the cases there are chronic arthritis and hypotension. Postmortem examination reveals a striking and unusual picture of macrophages in the wall of the small intestine and fat granulomas of the mesenteric lymph nodes.

Four patients with this condition have come to autopsy in Duke Hospital: this we believe to be the largest series seen in any one clinic. One of these patients (case 1) was followed by one of us (J. P. H.) at intervals throughout his illness, and the diagnosis was made during life by means of biopsy of a mesenteric lymph node. We believe this to