Horowitz S, Lorenzsonn V W, Olsen W A, Albrecht R, Hong R
J Pediatr. 1974 Oct;85(4):457-62. doi: 10.1016/s0022-3476(74)80444-0.
Biopsies of the proximal small bowel were obtained in four children with impairment of cell-mediated immunity, chronic diarrhia, and malabsorption; one child had an isolated T cell defect and three had significant B and T cell defects. All of them had malabsorption and, in addition to alterations of the small bowel epithelium, large vacuolated macrophages were seen in the lamina propria in all biopsies. Electron microscopy demonstrated lipid and patches of small pleomorphic inclusions within the macrophages. Since large vacuolated macrophages have also been described in Whipple's disease and chronic granulomatous disease, we suggest the possibility of a common thread of defective host defense and gastrointestinal malfunction in these three conditions.
对4名细胞介导免疫受损、慢性腹泻和吸收不良的儿童进行了近端小肠活检；1名儿童有孤立的T细胞缺陷，3名儿童有明显的B细胞和T细胞缺陷。他们都有吸收不良，除小肠上皮改变外，所有活检标本的固有层均可见大的空泡状巨噬细胞。电子显微镜显示巨噬细胞内有脂质和小的多形性包涵体斑块。由于在惠普尔病和慢性肉芽肿病中也有大的空泡状巨噬细胞的描述，我们认为在这三种疾病中可能存在宿主防御缺陷和胃肠道功能障碍的共同线索。
