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August 1963

Whipple's Disease With Associated Splenomegaly and Pancytopenia

Arch Intern Med. 1963;112(2):207-211. doi:10.1001/archinte.1963.03860020105013

The protean nature of Whipple's disease (intestinal lipodystrophy) is well recognized. The approximately 80 cases which have been documented since Whipple's description in 1907 1 include as manifestations polyarthritis, polyserositis, visceral and peripheral lymphadenopathy, diarrhea with steatorrhea, weakness, weight loss, abdominal pain, low-grade fever, hypochromic normocytic anemia, hypotension, chronic cough, cutaneous pigmentation, purpuric lesions, and progressive presenile dementia.2-9 To our knowledge, however, this case represents the first reported example of splenomegaly and pancytopenia complicating Whipple's disease.

Report of Case  A 69-year-old white male retired telephone lineman was first admitted to Brooke General Hospital on May 9, 1960, with an eight-year history of frequent intermittent bouts of diarrhea of foulsmelling, bulky, and mucus-containing stools and periodic edema of the lower extremities. He had also gradually lost 20 lb of weight.On physical examination height was 67 in (170.2 cm), weight 113 lb (51.3 kg), temperature 102 F (38.9 C), pulse