JEJUNAL BIOPSIES IN SPRUE

Abstract

Jejunal biopsies were obtained at the time of surgery for unrelated causes from 6 Puerto Rican subjects with malabsorption. In comparison with normal material these specimens revealed (1) widening of villi, (2) inflammatory and degenerative changes in columnar epithelium, and (3) an infiltration of the lamina propria with granular leucocytes and chronic inflammatory cells. In an untreated patient, estimates indicated a 75% reduction in absorptive surface area, a factor which is considered contributory to impaired absorption. Abnormally large nuclei were observed in buccal squamous epithelium and in jejunal columnar epithelium of subjects with megaloblastic anemia, suggesting a widespread disorder of cellular proliferation. In view of the rapid turnover time of columnar epithelium, it is suggested that an impaired production or survival of these cells may account for some of the observed pathological changes.