Rare infectious malabsorption syndrome, with diarrhea, migratory polyarthritis & lymphadenopathy.

Demographics

Caucasian farmers, genetically susceptible (HLA, DRB1)

Microscopy

• Plenty of foamy macrophages in mucosa, full of partly digested rod-shaped bacilli Tropheryma whippelii gram +ve, actinomycete. PAS stain positive.
• Little or no inflammation.

Pathophysiology

Malabsorption due to lymphatic block from macrophages

Antibiotic therapy