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The glycocalyx and the structure of the microvilli were analysed in electron microscopy in 122 children with coeliac disease and secondary syndromes of malabsorption. Slight differences were noted in glycolayx structure between both groups of children. In children with coeliac disease its reduction was noted (after gluten challenge). Changes were observed also in the structure of the microvilli. They were lower and often with abnormal shape in coeliac disease, while they were high and of normal structure in secondary malabsorption syndromes.

The results of bioptic mucosal specimens examination are discussed. Samples of the small intestine were collected from 211 children with malabsorption syndrome of various etiology such as cow milk protein intolerance, gluten intolerance, spontaneous diarrhoea and other. The results obtained with microscopic examination scored with Shmerling scale were compared with those of light microscopic examination of histological preparations. The difficulties connected with proper sampling and handling of the bioptic specimen are discussed. Technical errors very often are the cause of the diagnostic failure.

In 92 children aged 3 to 24 months with suspected malabsorption syndrome the nutritional status was assessed, the results of routine diagnostic laboratory tests were analysed, and the correlation was sought between these parameters and the degree of atrophy of intestinal villi. A correlation was demonstrated between body weight deficit and the pathological result of the d-xylose test and the degree of villous atrophy only in the group of infants, and in children in the second year of life the changes of these parameters were not useful in the diagnosis of the malabsorption syndrome. The assessment of the shape of iron and glucose absorption curve shows a low usefulness nof these tests, and they should not be used in the diagnosis of the syndrome.