Whipple's disease: demonstration by immunofluorescence of similar bacterial antigens in macrophages from three cases

Although it is widely accepted that Whipple's disease is caused by microorganisms, there is little agreement as to their exact nature. Several different types of bacteria have been reported from patients with Whipple's disease causing some workers to speculate that Whipple's disease may be due to a variety of microorganisms. Using an indirect immunofluorescence technique, the authors demonstrated bacterial antigens in the granules of the foamy macrophages from 3 patients with Whipple's disease. The macrophages in each case stained with several types of antibacterial grouping sera. Jejunal biopsies from 3 normal subjects and one from a patient with a celiac like disease did not show significant reactions with any of the antisera. The reaction of these same antisera with homologous and heterologous bacteria showed numerous cross reactions. However, each organism only reacted with certain antisera resulting in a distinctive reaction pattern which could identify it. Therefore, if a different organism was present in each case of Whipple's disease, the antisera should give dissimilar reactions from case to case, but if the same type of microorganism was present in each case, a similar pattern of reaction should be seen. In fact, the reactions were remarkably similar from case to case. These results suggest that a single, antigenically definable microorganism is present in the jejunal tissue of patients with Whipple's disease.