LYMPHOCYTES IN WHIPPLE'S DISEASE

A bacterial ætiology for Whipple's disease has been suggested, but no single organism has been implicated. In a 53-year old patient with typical Whipple's disease, a jejunal biopsy specimen showed a striking lack of plasma-cells and lymphocytes in the lamina propria which suggested the possibility of an immunological deficit. Investigation of the patient's immunological profile after chemotherapy for 15 months revealed normal immunoglobulins and antibody to Streptococcus and Salmonellœ. The peripheral lymphocytes were morphologically normal, as was the lymphocyte-count. There was considerable impairment of phytohæmagglutinin-induced lymphocyte transformation. These findings support the hypothesis that Whipple's disease may be the result of failure of cell-mediated immune mechanisms.