SUCCESSFUL CORTICOTROPIN (ACTH) THERAPY OF WHIPPLE'S DISEASE REFRACTORY TO CORTISONE

Abstract

WE REVIEWED in 1950 the 33 cases of lipophagic intestinal granulomatosis published through 1948 and reported an additional one.¹ Aside from its resemblance to the intestinal and mesenteric lipogranulomas, it became obvious during that study that lipophagic intestinal granulomatosis has certain clinical and pathological resemblances to the so-called collagen disorders, such as recurrent polyarthritis, polyserositis, endocardiosis² or endocarditis, and histologic evidence of mesenchymal chronic inflammation.² This condition also has a broad clinical resemblance to chronic adrenocortical insufficiency, especially in regard to susceptibility to nonspecific stress. Kampmeier and Peterson,³ working independently from us, likewise concluded that Whipple's disease properly should be included within the heterogenous entities known as the "rheumatic state." Also, in 1950, the studies of Hendrix and his associates² added further impetus to this concept by suggesting a hyperergic factor involved in the pathogenesis, indicating a like thought trend. Just prior to our last communication, Hench and his group