American Journal of Clinical Nutrition, Vol 22, 744-754, Copyright © 1969 by The American Society for Clinical Nutrition, Inc.

Small Intestinal Structure and Absorption in Egypt

Influence of Parasitism and Pellagra

¹ From the United States Naval Medical Research Unit no. 3, (NAMRU-3), and Department of Medicine, Ain Shams University, Cairo, United Arab Republic

Small intestinal structure and function were assessed in Egypt in 14 subjects with no intestinal disease and in 33 patients with hookworm disease or pellagra. The intestinal biopsies in the control group were characterized by mild inflammation, whereas more severe mucosal injury was observed in 43.5% of the patient groups. The degree of mucosal injury was not affected by the severity of parasitic infection. Intestinal lactase levels were decreased in 22 of 23 biopsy specimens. Subnormal absorption of d-xylose was observed with equal frequency in healthy subjects and in patients with parasitism or pellagra. Steatorrhea occurred in four patients with low serum albumin levels and in each instance was corrected by a hospital diet without definitive treatment of parasitism.

In Egyptian farmers, endemic intestinal parasitism and pellagra is associated with a high incidence of jejunal mucosal injury, which bears no obvious relationship to intestinal absorption. The specific cause of the steatorrhea that occurs in protein-malnourished patients is unclear. Our data suggest several further lines of investigation.