CLINICO-PATHOLOGICAL exercise; intestinal lipodystrophy.
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Like Mongolian gerbils (Meriones unguiculatus), Meriones libycus develop an intestinal lipodystrophy due to myo-inositol deficiency. Fat accumulation was observed in the intestine of both species when a myo-inositol-deficient diet containing coconut oil was fed to female gerbils. It began in the duodenum and gradually extended to the entire small intestine. Starvation partially removed the accumulated fats. The efficiency of fat absorption was not affected. Most of the accumulated fats were lauric acid-rich triglyceride with the fatty acid composition reflecting the pattern of the intestinal lymph triglyceride during normal transport of absorbed coconut oil. The ratio of oleic acid to linoleic acid in various intestinal lipids was increased. A marked decrease in all plasma lipid and lipoprotein concentrations, including chylomicron, was also observed. It is assumed that the intestinal fat accumulation resulted from a defect in lymphatic transport of dietary fats.
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The case of a 48 years old man with intestinal lipodystrophy (Whipple's disease) is clinically, roentgenologically, endoscopically and histologically documented. The diagnosis was established by endoscopic biopsy and laparatomy. The patho-histologic changes of the mucosa of the proximal small bowel are pathognomonic. Roentgenologically the characteristic mucosal and lymphadenoid changes can be demonstrated as well as the extent of the process.
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