ABSTRACT
Coeliac disease must be regarded as a premalignant condition as small bowel lymphoma may supervene usually at or beyond middle age. Symptoms suggestive of lymphoma include deterioration of health, abdominal discomfort and diarrhoea despite keeping to a gluten free diet, gastrointestinal bleeding, or skin rashes. Signs include anaemia, lymphadenopathy, clubbing, abdominal distension, and hepatomegaly. Whipple’s disease is caused by Gram-negative actinomycete Tropheryma whippeli. Common features of infection include malabsorption which is almost always present, skin pigmentation, peripheral lymphadenopathy, arthralgia, abdominal pain, diarrhoea progressive weight loss, and low-grade fever. Fatty infiltration of the liver can occur in a number of conditions including obesity, pregnancy, alcoholism, diabetes mellitus, inflammatory bowel disease, starvation, early stages of chronic liver disorders, example, Wilson’s disease, and conditions associated with general debility and malnutrition such as TB and cystic fibrosis.
