Figure 5

Lymphocyte and duodenal enterocyte ultrastructure in idiopathic parkinsonism (IP). Electron micrographs shows mitochondria in a representative blood lymphocyte from (a) a man with clinically-definite lP and (b) an age-matched healthy man, and in a representative duodenal enterocyte from (c) this IP-proband (panel to right shows higher magnification) and (d) his spouse. The proband's normal lymphocyte mitochondria are in marked contrast to his and his spouse's long thin duodenal mitochondria. The proband's IP had been diagnosed 7 years previously. He was receiving anti-parkinsonian medication. His spouse had probable-IP on screening. Both had bloating and cyclical diarrhoea going back 10 years. Typically, in the proband, 4 days of unformed stool alternated with constipation in a four-week cycle. In the spouse, explosive watery diarrhoea followed abdominal cramps, over 2 days in 2 week cycles, with normal bowel habit in between. Both had a positive hydrogen-breath-test (criterion: two consecutive values [37] >cut-point of meter manufacturer), and were negative for Helicobacter by UBT, serology, and culture/molecular microbiology on gastric biopsy.