Article. Published in Russian Journal of Gastroenterology, Hepatology, Coloproctology No 5, 2008, pp 80 - 85. and . In. Maev, E. In. Gilyaev, D. T. Wild, T. A. Buragina, O. E. Berezutskaya, N. L. Golovkina . Department of Propaedeutics of Internal Diseases and Gastroenterology of the Moscow State Medical and Dental University, Main Clinical Hospital of the Ministry of Internal Affairs of Russia . Purpose of clinical observation. Demonstrate features of clinical manifestations of Whipple's disease and treatment of the disease; compare with the literature's own two-year experience of monitoring the patient. Features of clinical observation . The patient is 56 years old diagnosed with Whipple's disease of a typical course with characteristic symptoms of diarrhea, weight loss, other signs of malabsorption and articular syndrome. The complexity of the diagnosis of Whipple's disease was that extraintestinal manifestations long preceded the clinical symptoms that dominated the expanded stage of the disease. Decisive for the diagnosis was the identification of the patient in the histological examination of the mucosa of the small intestine of macrophages containing PAS-positive granules .. The difficulty of treatment in the described case was, that after the appointment of biseptol 960 mg/day for 4 months followed by alternation of biseptol and erythromycin 1000 mg/day (2 weeks each drug) remained pronounced joint syndrome, What was the reason for the continuation of antibiotic therapy . Conclusion. Whipple's disease should be combined with damage to the joints, cardiovascular, bronchopulmonary and nervous systems. The diagnosis is confirmed in the presence of macrophages in the lymph nodes and intestines containing PAS-positive material .