Studies of the small bowel surface by scanning electron microscopy in infants with persistent diarrhea

Studies of the small bowel surface by scanning electron microscopy in infants with persistent diarrhea

Autor Fagundes-Neto, Ulysses Autor UNIFESP Google Scholar
De Martini-Costa, S. Autor UNIFESP Google Scholar
Pedroso, Margareth Zabeu Autor UNIFESP Google Scholar
Scaletsky, Isabel Cristina Affonso Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo We describe the ultrastructural abnormalities of the small bowel surface in 16 infants with persistent diarrhea. The age range of the patients was 2 to 10 months, mean 4.8 months. All patients had diarrhea lasting 14 or more days. Bacterial overgrowth of the colonic microflora in the jejunal secretion, at concentrations above 10(4) colonies/ml, was present in 11 (68.7%) patients. The stool culture was positive for an enteropathogenic agent in 8 (50.0%) patients: for EPEC O111 in 2, EPEC O119 in 1, EAEC in 1, and Shigella flexneri in 1; mixed infections due to EPEC O111 and EAEC in 1 patient, EPEC O119 and EAEC in 1 and EPEC O55, EPEC O111, EAEC and Shigella sonnei in 1. Morphological abnormalities in the small bowel mucosa were observed in all 16 patients, varying in intensity from moderate 9 (56.3%) to severe 7 (43.7%). The scanning electron microscopic study of small bowel biopsies from these subjects showed several surface abnormalities. At low magnification (100X) most of the villi showed mild to moderate stunting, but on several occasions there was subtotal villus atrophy. At higher magnification (7,500X) photomicrographs showed derangement of the enterocytes; on several occasions the cell borders were not clearly defined and very often microvilli were decreased in number and height; in some areas there was a total disappearance of the microvilli. In half of the patients a mucus-fibrinoid pseudomembrane was seen partially coating the enterocytes, a finding that provides additional information on the pathophysiology of persistent diarrhea.
Palavra-chave persistent diarrhea
small bowel
scanning electron microscopy
bacterial proliferation
Idioma Inglês
Data de publicação 2000-12-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 33, n. 12, p. 1437-1442, 2000.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 1437-1442
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000166117900006
SciELO S0100-879X2000001200006 (estatísticas na SciELO)
Endereço permanente

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