An electron-microscopic study of jejunal mucosal morphology in control subjects and in patients with tropical sprue in southern India.

The ultrastructure of the jejunal mucosa obtained by peroral biopsy from 7 control subjects and 12 patients with tropical sprue was studied. Compared with biopsies from control subjects in temperature zones, southern Indian control subjects showed minimal increase in lysosomes in surface epithelial cells, an occasional dark-staining degenerating epithelial cell in the upper two-thirds of villi, and an increase in cellular infiltration of surface epithelium and lamina propria. The jejunal epithelial cells of tropical sprue patients had abnormal microvilli, marked increase in lysosomes, increase in intracellular fat, and degenerative changes in rough endoplasmic reticulum and mitochondria. Two types of degenerating epithelial cells, designated pale and dark based on their staining quality, were seen in the villi. Pale staining degenerating cells were also seen in the crypts. The basement membrane region showed an amorphous deposit with many collagen fibers and fat droplets. The epithelial layer and lamina propria showed increased cellular infiltration. In one biopsy from a patient with sprue, particles of possible viral origin were seen.