par Barbier, Pierre;Ketelbant Balasse, Paule 
;Kennes, Bernard
Référence Archives Francaises des Maladies de l'Appareil Digestif, 64, 8, page (659-666)
Publication Publié, 1975
;Kennes, Bernard Référence Archives Francaises des Maladies de l'Appareil Digestif, 64, 8, page (659-666)
Publication Publié, 1975
Article révisé par les pairs
| Résumé : | Although the infectious origin of Whipple disease is well documented, immunologic factors seem to be an important predisposing factor. In the present case, the following aspects of the disease are reported: clinical, biologic, bacteriologic (Corynebacterium anaerobium), microscopic and electronic pathology. The latter demonstrates bacterial structures in the intercellular spaces which are progressively destroyed. Immunologic study indicates only slightly abnormal status of the humoral immune response, contrasting with the deeply depressed cell mediated immune reactions. There is a negative candidin and streptokinase streptodornase (SKD) skin test. The in vitro lymphocyte culture demonstrates a greatly reduced response to PHA and an abnormally low secretion of MIF (migration inhibitory factor) in response to SKD. There are very few IgA plasmocytes in the intestinal mucosa. After 1 yr therapy, the only improved test of cell mediated immunity is the MIF response. The significance of the immunologic disorders reported in the case presented (a woman of 74), is still unknown as far as the pathogenesis and clinical evaluation are concerned. |
