JEJUNAL WATER AND ELECTROLYTE TRANSPORT IN HUMAN CRYPTOSPORIDIOSIS

Cryptosporidiosis may have severe clinical consequences in both immuno compromised and immunocompetent individuals. However, pathophysiologic al mechanisms that are responsible for diarrhea are poorly understood. We performed jejunal perfusion studies in patients with human immunod eficiency virus-related cryptosporidial diarrhea to measure water and electrolyte transport in vivo. Five patients with human immunodeficien cy virus-related cryptosporidiosis and nine healthy volunteers were st udied using a triple-lumen steady-state jejunal perfusion technique. S tool volume measurement and distal duodenal biopsy showed that the pat ients had diarrhea (600-1500 ml/24 hr) and morphological abnormalities of small intestinal mucosa. Net water, sodium, and chloride movement in the jejunum was not significantly different from healthy controls. In these patients with watery diarrhea and morphological mucosal abnor malities, we found no evidence that cryptosporidial diarrhea was due t o a secretory state in the proximal small intestine. We conclude that diarrhea may be due to secretion of electrolytes and water efflux more distally or to other abnormalities of gastrointestinal function.