β-thalassemia minor, carbohydrate malabsorption and histamine intolerance

ABSTRACT

Background: β-thalassemia minor is characterized by reduced β-haemoglobin chain synthesis and sometimes mild anaemia, although carriers of β-thalassemia minorare usually clinically asymptomatic.Nonspecific abdominal complaints may be caused by gastrointestinal carbohydrate malabsorption (lactose and fructose) and/or malabsorption of biogenic amines (histamine), or proteins (gluten).

Objectives: We report on two patients with β-thalassemia minor suffering nonspecific abdominal symptoms due to a carbohydrate and histamine malabsorption.

Design/methods: The diagnosis of β-thalassemia minorwas done with peripheral blood smear and cellulose acetate electrophoresis. Carbohydrate malabsorption was diagnosed with hydrogen breath tests and, histamine intolerance (HIT) with a serum diamine oxidase value <10 U/ml and more than two gastrointestinal symptoms described for HIT.

Conclusion: The symptoms of gastrointestinal malabsorption in these two patients with β-thalassemia minor were treated successfully with an individually-tailored diet free of symptom causing carbohydrates and histamine.

KEYWORDS:

• β-thalassemia minor
• lactose intolerance
• fructose malabsorption
• histamine intolerance
• nonspecific abdominal complaints
• diet

Disclosure statement

Wolfgang J. Schnedl received speaking honoraria from Sciotec Diagnostic Technologies. The other authors declare no conflict of interest.

Additional information

Funding

The authors have received no funding for this manuscript.All authors have approved the final version of this manuscript.