622 giardiasis, mucus and malabsorption. A scanning (sem) and transmission (tem) electron microscopic study of small bowel mucosa

ABSTRACT Infestation with Giardia Lamblia (GL) may be associated with malabsorption, the pathogenesis of which continues to be under investigation. Recent observations in 2 children with

giardiasis, including careful examination of biopsied small intestinal mucosa by SEM and TEM, has provided additional information, which may help to explain presence or absence of

malabsorption. Two children, aged 2 and 2½ years with diarrhea of 3 to 4 months' duration underwent diagnostic workup, including small bowel biopsy. Stool examinations were negative,

and serum immunoglobulins, and mucosal morphology by light microscopy normal in both. Biochemical indices indicated malabsorption in one of the children, but not in the other. SEM of the

mucosa of the child with malabsorption showed that wide areas of villous surfaces were covered with sheets of mucus of variable thickness (1.5-4.0μ). The microvilli were shortened. By

contrast, the villous surfaces of the child without malabsorption were free of mucus, and most GL were trapped in mucus at the base of the villi. Mucosal invasion was not a major finding.

These observations suggest that increased secretion (crypts) and deposition of mucus produces an effective diffusion barrier to nutrients, explaining malabsorption phenomena and, possibly,

subsequent adverse trophic effects on the mucosa. The proclivity to secrete mucus in response to the infestation with GL in humans may be determined genetically and/or environmentally.

ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Departments of Pediatrics and Anatomy, Eastern Virginia Medical School, Norfolk, 23507, Virginia J Rainer Poley, Sheila Rosenfield 

& Albert W Klein Authors * J Rainer Poley View author publications You can also search for this author inPubMed Google Scholar * Sheila Rosenfield View author publications You can also

search for this author inPubMed Google Scholar * Albert W Klein View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and

permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Poley, J., Rosenfield, S. & Klein, A. 622 GIARDIASIS, MUCUS AND MALABSORPTION. A SCANNING (SEM) AND TRANSMISSION (TEM) ELECTRON

MICROSCOPIC STUDY OF SMALL BOWEL MUCOSA. _Pediatr Res_ 15 (Suppl 4), 544 (1981). https://doi.org/10.1203/00006450-198104001-00635 Download citation * Issue Date: 01 April 1981 * DOI:

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