Scanning electron microscopy of normal and celiac jejunal mucosa

Suction biopsies of normal and celiac jejunal mucosa have been studied using a scanning electron microscope. The normal villus pattern, crypt openings and surface details have been demonstrated and contrasted with the appearance of the mucosa in untreated celiac disease and in patients on a gluten-free diet. In the celiac the epithelial cells are smaller and more rounded than normal, an abnormality which may persist after gluten withdrawal. This appearance suggests a loose attachment of the cells to each other and to the supporting connective tissue, which in turn suggests a mechanical explanation for the increased cell loss and turnover in celiac disease.