Intestinal absorptive status and gut contamination among Egyptian thalassemic children

In this study, the intestinal absorptive status and the prevalence of small bowel bacterial overgrowth were assessed in 72 thalassemic children. They were classified according to the onset of the disease, the splenic status and type of chelation therapy into three groups. Group I included 15 newly diagnosed cases. Group II included 30 thalassemic children receiving subcutaneous desferrioxamine [DF] as a chelation therapy [15 of them had intact spleen and 15 were splenectomized]. Group III included 27 patients receiving oral salicylhydroxamic acid [SHAM] as a chelation therapy [12 of them had intact spleen and 15 were splenectomized]. Fifteen healthy age and sex matched children served as controls. The results revealed that the levels of fecal alpha-1 antitrypsin [a marker of enteric protein loss] were significantly higher in all studied groups as compared with the control group. In conclusion, malabsorption was a common finding in thalassemic patients regardless of the duration, type of chelation therapy and whether splenectomized or not. Furthermore, small bowel bacterial overgrowth was also common in thalassemic cases, especially the splenectomized ones due to the profound immune disturbances occurring after splenectomy