- affects middle aged while males
- presents with arthralgia/arthritis (seronegative arthropathy ~70%), diarrhea (70%), abdominal pain, fever and skin darkening
- severe malabsorption results in weight loss (90%) and along with fatigue and weakness caused by anemia
- also heart, lung, eye and brain involvement
- oculomasticatory myorrhythmia is characteristic
- small bowel (jejunal) biopsy: PAS positive macrophages in lamina propria
- most lesions (except cerebral) are reversible on prolonged antibiotic therapy
- treatment: amoxicillin, tetracycline, cotrimoxazole for 1 year
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