{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T14:29:07Z","timestamp":1698071347903},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"571","license":[{"start":{"date-parts":[[1973,5,1]],"date-time":"1973-05-01T00:00:00Z","timestamp":105062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1973,5,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>The patient, a 54-year-old housewife, was well until the age of 40 years when she developed repeated infections. During the next 10 years recurrent attacks of diarrhoea also appeared and were associated with weight loss, increased skin pigmentation, and later the occurrence of arthralgia and polyserositis. She was found to have deficiencies of IgG and IgA. A malabsorption syndrome was established and shown to be due to Whipple's disease by jejunal biopsy. She also had hypocalcaemia and osteomalacia. Weekly injections of human gammaglobulin had no effect on either the diarrhoea or the arthralgia, although the severity of respiratory infections was reduced. Intramuscular injections of vitamin D failed to restore the serum calcium to normal. Continuous oral tetracycline was followed by marked symptomatic improvement, disappearance of the diarrhoea and some weight gain. Steatorrhoea however persisted and the jejunal histology showed only slight improvement. The serum calcium returned to normal possibly as a result of correction of a magnesium deficiency. The relevance of the hypogammaglobulinaemia to the Whipple's disease is discussed, and a search of the literature shows six other cases where both disorders were associated.<\/jats:p>","DOI":"10.1136\/pgmj.49.571.355","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T20:31:39Z","timestamp":1230582699000},"page":"355-358","source":"Crossref","is-referenced-by-count":8,"title":["Hypogammaglobulinaemia with Whipple's disease"],"prefix":"10.1093","volume":"49","author":[{"given":"M","family":"Cochran","sequence":"first","affiliation":[{"name":"Medical Research Council Mineral Metabolism Unit, The General Infirmary , Leeds"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J C","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Medical Research Council Mineral Metabolism Unit, The General Infirmary , Leeds"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M G","family":"Cook","sequence":"additional","affiliation":[{"name":"University Department of Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Peacock","sequence":"additional","affiliation":[{"name":"Medical Research Council Mineral Metabolism Unit, The General Infirmary , Leeds"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1973,5,1]]},"reference":[{"key":"ref_1","first-page":"650","article-title":"Agammaglobulinaemia complicating Whipple's disease: Case report","volume":"57","author":"ANTON, A.T.","year":"1961","unstructured":"ANTON, A.T. (1961) Agammaglobulinaemia complicating Whipple's disease: Case report. Ohio Medical Journal, 57, 650.","journal-title":"Ohio Medical Journal"},{"key":"ref_2","first-page":"477","article-title":"Diagnostic problems of partially treated Whipple's disease: Report of a case with isolated deficiency of immunoglobulin M","volume":"110","author":"BERENS, S.C.; COHEN, R.A.; SCHWABE, A.D.","year":"1969","unstructured":"BERENS, S.C., COHEN, R.A. & SCHWABE, A.D. (1969) Diagnostic problems of partially treated Whipple's disease: Report of a case with isolated deficiency of immunoglobulin M. California Medicine, 110, 477.","journal-title":"California Medicine"},{"key":"ref_3","first-page":"535","article-title":"The rarer arthritic syndromes. In: Textbook of Rheumatic Diseases","author":"BYWATERS, E.G.L.; ANSELL, B.","year":"1969","unstructured":"BYWATERS, E.G.L. & ANSELL, B. (1969) The rarer arthritic syndromes. In: Textbook of Rheumatic Diseases (Ed. by W. S. C. Copeman), 4th edn, p. 535. 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(1970) Immunoglobulins in some diseases."},{"key":"ref_9","first-page":"669","volume":"3","unstructured":"British Journal of Hospital Medicine, 3, 669.","journal-title":"British Journal of Hospital Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1177\/003591576305601211","article-title":"The histology of intestinal biopsies","volume":"56","author":"HOURIHANE, D.O.'B.","year":"1963","unstructured":"HOURIHANE, D.O'B. (1963) The histology of intestinal biopsies. Proceedings of the Royal Society of Medicine, 56, 1073.","journal-title":"Proceedings of the Royal Society of Medicine"},{"key":"ref_11","first-page":"321","article-title":"The pathology of malabsorption states. In: Recent Advances in Pathology","author":"HOURIHANE, D.O.'B.","year":"1966","unstructured":"HOURIHANE, D.O'B. (1966) The pathology of malabsorption states. In: Recent Advances in Pathology (Ed. by C. V. Harrison), 8th edn, p. 321. Churchill, London.","edition":"8th edn"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/00005792-197005000-00001","article-title":"Whipple's disease: a review of nineteen patients from one hospital and a review of the literature since 1950","volume":"49","author":"MAIZEL, H.; RUFFIN, J.M.; DOBBINS, W.O.","year":"1970","unstructured":"MAIZEL, H., RUFFIN, J.M. & DOBBINS, W.O. (1970) Whipple's disease: a review of nineteen patients from one hospital and a review of the literature since 1950. Medicine, 49, 175.","journal-title":"Medicine"},{"key":"ref_13","first-page":"623","article-title":"The small intestine in Whipple's disease","volume":"81","author":"MARTEL, W.; HODGES, F.J.","year":"1959","unstructured":"MARTEL, W. & HODGES, F.J. (1959) The small intestine in Whipple's disease. 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