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April 1952

WHIPPLE'S DISEASEReview of the Literature and Report of Two Cases

AMA Arch Intern Med. 1952;89(4):600-614. doi:10.1001/archinte.1952.00240040079010

WHIPPLE, in 1907, described a "disease characterized anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues."1 The case he reported was "characterized by gradual loss of weight and strength, stools consisting chiefly of neutral fat and fatty acids, indefinite abdominal signs, and a peculiar multiple arthritis." In naming this syndrome he decided upon "intestinal lipodystrophy," which term has been used since; however, this name has recently been shown not to be fully appropriate.

The disease is encountered predominantly in middle-aged men. The usual duration of symptoms has been one to five years. Abdominal symptoms have been indefinite, although some patients presented sharp or colicky abdominal pains. Progressive loss of weight, weakness, lassitude, and, later, a progressive diarrhea were prominent symptoms. Migratory arthritis, generally with an absence of fever, was another frequent complaint. Hypotension, with brown pigmentation of the skin and oral mucosa, often

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