MORPHOLOGIC BASIS FOR GLUCOSE MALABSORPTION IN INFANTS WITH ACQUIRED MONOSACCHARIDE INTOLERANCE (AMI)

Infants with AMI have chronic acidic diarrhea secondary to malabsorption of all carbohydrates resulting in profound malnutrition. Four patients with AMF were studied by an intestinal perfusion technique. A triple lumen tube with a Pediatric Crosby capsule at the tip was introduced into the jejunum. A 10% glucose solution was infused through a proximal site 30 cm from the collecting point. 1% polyethylene glycol was added as a non-absorbable marker. Samples were obtained every 15 minutes and glucose absorption rate was calculated. After the perfusion, a jejunal biopsy was obtained for histology and disaccharidase assay.Glucose absorption increased from 9.2 to 17.3 mg/min after 1 month rehabilitation. Villous length increased with recovery. Lactase, sucrose and maltose enzymes remained low.A linear relationship exists between glucose absorption and villous length. This implies that impaired glucose absorption is related to decreased mucosal surface area. Work supported by: Ross Laboratory, David Underwood Trust, NASA Contract 90059, USPH RR-00188 and AM-05721-01.