SERUM AND FECAL PANCREATIC-ENZYMES IN BETA-THALASSEMIA MAJOR

Conclusion. This study, using indirect tests, demonstrated that exocri ne pancreatic function is impaired in a proportion of patients with be ta-thalassemia major (TM), though this impairment is generally mild or moderate. Background. Impaired structure and function of the exocrine pancreas has been reported in patients with Beta-thalassemia major. M ethods. In this study we measured fecal fats and serum and fecal pancr eatic enzymes in 30 patients (13 M, 17 F) with TM, mean age 22.1 yr (r ange 14-39) and compared them with those of a matched group of healthy controls. Results were correlated with age, serum ferritin, blood tra nsfusion, and various nutritional parameters. Enzymes assays included: serum pancreatic amylase (PA), lipase (L), trypsin (T), fecal chymotr ypsin (FCT), and fecal elastase (FE). Results. No patient was positive for steatorrhea. Comparison of the mean values showed a significant d ifference only for FE (p < 0.002). Using only the fecal tests as a ref erence, we found that 12 patients had FE values below the cutoff limit ; of these, five had values between 100 and 185 mu g/g, three between 50 and 99 mu g/g and four below 50 mu/g. Ten patients had FCT values b elow the cutoff limit; seven presented impairment in both tests and si x of them had FE values below 100 mu g/g (including four diabetics). N o correlations were found between enzyme values and mean serum ferriti n values or mean blood consumption over the previous 3 yr. No correlat ion was found between FE and FCT levels or between enzymes and age.