Whipple Disease

To the Editor. —  The case report by DeLuca et al (233:59, 1975) of Whipple disease in a white patient older than the expected age, who also had a prolonged prodromal arthritis, prompts our reporting two cases of Whipple disease seen at the Eugene Talmadge Memorial Hospital in the past 12 years. Both cases illustrate unusual features of Whipple disease: a woman in whom the initial manifestation was fever of undetermined origin and a black man with prolonged arthritis.

Report of Cases.—Case 1.—  A 61-year-old white woman who had fever of undetermined origin for seven years was discovered at autopsy to have Whipple disease. Her work-up had included an exploratory laparotomy five years before death at an outside hospital and an evaluation at a major diagnostic center one year prior to death. Symptoms seven years prior to admission were postprandial abdominal bloating, constipation for two to three days followed