Subclinical tropical enteropathy in Angola Peroral jejunal biopsies and absorption studies in asymptomatic healthy men

Peroral jejunal biopsies and absorption studies were performed on 19 European and 13 African young, asymptomatic healthy men living in Angola. Under the dissecting microscope, leaves and ridges predominated in all. A predominance of fingers or a flat mucosa was not observed. The calculated average severity of the alterations was significantly greater in Africans (P < 0.01). Histologic studies revealed an abnormal jejunal morphology in all, characterized by villus dystrophy, vacuolization of epithelial cells, edema and infiltration of the lamina propria by lymphocytes and plasmocytes. Significant statistical differences in the occurrence of the alterations in the two groups were not detected. An apparent thickening of the basal membrane was observed only in four Africans. Elongated crypts were present in one European and one African. Results of mucosal measurements did not differ statistically in the two groups. Malabsorption of d-xylose was present in two Europeans (14.3%) and two Africans (15.4%), and malabsorption of glucose, in four Europeans (21.1%) and five Africans (38.5%). Malnutrition, anemia, or parasitic infections were excluded as etiologic factors.