Evaluation of exocrine pancreas insufficiency in patients with iron-loaded beta thalassemia major

Introduction and purpose: It was aimed to evaluate the presence of exocrine pancreatic insufficiency due to iron load in patients with Beta Thalassemia Major, by fecal Elastase-1 level.These results were correlated with clinical and laboratory data. Material-Method:40 patients with beta thalassemia major and 42 healthy control groups who applied to Gaziantep University Faculty of Medicine Şahinbey Research and Application Hospital Hematology and Gastroenterology outpatient clinics between August 02 and September 15, 2021 were included in the study. The study is a prospective study. In our study; Blood and fresh stool samples were taken from patients and volunteers. Biochemistry, hemogram, iron parameters and fecal elastase-1 levels were compared between the control group and the patient group. Results: Based on Fe-1 level in the diagnosis of EPI, Fe-1>200 was considered normal, 100-199 mild-moderate, and <100 severe exocrine pancreatic insufficiency. In our study, in the BTM group; 15 (37.5%) were normal, 5 (12.5%) were mild-moderate, and 20 (50%) were severe. In the control group; 33 (78.57%) were normal, 3 (7.14%) were mild-moderate, and 6 (14.29%) were severe. Fe-1 level was found to be significantly lower in the patient group than in the control group (p<0.05). When laboratory parameters were examined, urea, BUN, total protein, total bilirubin, direct bilirubin, indirect bilirubin, AST, ALP, GGT, LDH, triglyceride, serum iron, ferritin, leukocyte, neutrophil, thrombocyte and lymphocyte values were significantly higher in the patient group than in the control group. (p<0.05). On the contrary, creatinine, total cholesterol, LDL cholesterol and HDL cholesterol, UIBC, TIBC, MCV and Hb values were found to be significantly lower in the patient group than in the control group (p<0.05). Conclusion: In this study, the relationship between iron accumulation and EPI in transfusion-dependent BTM patients was investigated and demonstrated. Fe-1 levels were found to be low in transfusion-dependent BTM patients.These results show that Fe-1 values can be used in the diagnosis of EPI in BTM patients. Key words: Beta thalassemia major, fecal elastase, exocrine pancreatic insufficiency