Low power shows small intestinal villi which are largely intact but wider than usual Image

THe villus to the right -- lamina propria distented by pale histiocytes. The overlying epithelium appears intact. Image

No significant inflammation but sheets of pink histiocytes in the villous frond Image

PAS positive histiocytes Image

Whipple disease is a chronic, relapsing multisystem disease resulting from an organism in the member of the order Actinomycetes -- Tropheryma whipplei. There is no documented mode of transmission for this organism. Affected individuals have been shown to have cutaneous anergy, decreased monocyte phagocytosis, subtle defects in T cell function, and a decreased ability to degrade the organism.

Most commonly patients present with diarrhea, weight loss and abdominal pain. The vast majority also also manifest a period of relapsing arthropathies, lymphadenopathy, fever, and hyperpig

Some develop pancarditis with endocarditis and neurological symptoms, which on occasion may be the presenting symptoms. Some CNS findings include hypothalamic disturbances, including sleep disruptions, hyperphagia, polydypsia, or headache, ataxia, deafness, weakness, and dementia.

ESR is frequently elevated.

Antibiotic therapy is typically prescribed for 1 to 2 years.