Macrophages containing large quantities of undigested and paial digested bacteria in intestine are seen in -

Ans. is 'a' i.e., Whipple's DiseaseThe hallmark of Whipple's disease is a small intestinal mucosa laden with distended macrophages in the lamina propria- the macrophages contain periodic acid-schiff (PAS) positive granules and rod shaped bacilli by electron microscopy.Three forms of Malabsorption Syndromes are often asked and the basic understanding of these is able to exclude a large number of questions. Whipple's DiseaseMalabsorption syndrome with systemic features with infectious etiologyEtioloevGram negative actinomycete Tropheryma whippeliiBiopsy DiagnosticLamina Propria is infiltrate with macrophages containing PAS positive glycoproteins and rod shaped baciliDilated lymphaticsClinical featuresFeatures of malasorption+ Array of systemic featuresTropical Sprue Malabsorption syndromeof infectious etiology without systemic featuresEtiologyCaused by some strainsof E.coliBiopsyAbnormal but Not DiagnosticShoened, thickened villi increased crypt depth infiltration by mononuclear cellsClinical featuresFeatures of malabsorptionCoeliac Disease Malabsorption syndrome of non infectious etiology without systemic featuresEtiologyCaused by intolerance to gliadin' gluten a protein found in wheat rye, barley.BiopsyAbnormal/Characteristic but Not DiagnosticBlunting and flattening of mucosal surface with villi either absent or broad and sho- Crypts are elongated- Dense infiltration of inflamma tory cells in lamina propria inflammatory.Clinical features Features of malabsorption Systemic features of whipple's diseaseo Polyahralgia o Psychiatric complaints --) Dementia o Ophthalmologic complaints o Lymphadenopathy o Hyperpigmentation