Diffuse specific lesions on intestinal biopsy are seen in-
Correct Answer: Whipples disease
Description: Whipple's disease is a rare, systemic infectious disease caused by the bacterium Tropheryma whipplei. Whipple's disease primarily causes malabsorption but may affect any pa of the body including the hea, brain, joints, skin, lungs and the eyes.Weight loss, diarrhea, joint pain, and ahritis are common presenting symptoms, but the presentation can be highly variable and approximately 15% of patients do not have these classic signs and symptoms. The most common symptoms are diarrhea, abdominal pain, weight loss, and joint pains. The joint pains may be due to migratory non-deforming ahritis, which may occur many years before any digestive tract symptoms develop; they tend to involve the large joints but can occur in any pattern and tend not to damage the joint surface to the point that the joint becomes deformed. Fever and chills occur in a small propoion of people. In its more advanced form, malabsorption (insufficient absorption of nutrients from the diet) leads to wasting and the enlargement of lymph nodes in the abdomen. Neurological symptoms (discussed below) are more common in those with the severe form of the abdominal disease. Chronic malabsorptive diarrhea leads to the poor absorption of fat, causing steatorrhea (fatty, offensive-smelling stool), flatulence, and abdominal distension. Protein-losing enteropathy may also occur, causing depletion of albumin, a blood protein, which may lead to peripheral edema caused by the lowered oncotic pressures Ref Davidson edition23rd pg810
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