[Letter: Serum hepatitis antigen].
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Biomedical subjects
Publications and source records attributed to F H Franken.
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Whipple's disease is characterized morphologically by macrophages in the small intestine which store PAS-postive material, as well as coarsening and atrophy of the intestinal villi, with pseudocystic cavitations. Without treatment it ends fatally due to irreversible diarrhoea and cachexia. Until 1963, only 90 cases had been diagnosed, most of them at autopsy. Intestinal biopsy has facilitated the diagnosis in life. Treatment with antibiotics results in dramitic improvement and remission for many years. From this an at least partial bacterial cause of the disease has been deducted, but it has not been possible so far to identigy more precisely any causative bacteria. Two cases of Whple's disease with some special features are reported. Both occurred in women (previous reports were almost entirely of men). The severely ill patients were cured by tetracycline within a few weeks and have remained completely well at follow-up examinations. The morphological changes in the intestinal mucosa had partially regressed.
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Melanosis coli is caused by deposits of malanin- or lipofuscin-containing pigments in the colon mucosa; it is a conspicuous sign of long standing abuse of anthrachinonic laxatives. Melanosis coli can be easily diagnosed during rectoscopy, using morphological as well as histological criteria; nevertheless this condition is often overlooked or goes unnoticed. Abuse of laxatives, which is denied or concealed rather often by patients, does however explain in many cases otherwise unexplained abdominal complaints. Four cases are reported demonstrating the diagnostic significance of colonic melanosis.
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