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  • Title: Iron loss and reabsorption in Ancylostoma duodenale infection and bilharzial colonic polyposis.
    Author: Farid Z, Bassily S, Lehman JS, Kent DC, Haxton J, Patwardhan VN, Hassan A.
    Journal: Trans R Soc Trop Med Hyg; 1970; 64(6):881-4. PubMed ID: 5495636.
    Abstract:
    Individuals infected with Ancylostoma duodenale may lose up to 6 mg of iron daily and those infected with bilharzial colonic polyposis may lose an average of 3 mg daily; patients suffering with both infections may lose up to 9 mg of iron daily. 1 study has shown that some iron loss to the upper gastrointestinal tract was reabsorbed. A study was undertaken to ascertain whether any iron lost in the lower gastrointestinal tract is reabsorbed and to measure the amount of iron reabsorbed in patients with A. duodenale. 7 Egyptian farmers with A. duodenale and 8 with bilharzial intestinal polyposis but without hookworm infection were given thorough physical and laboratory examinations. Hookworm and Schistosoma mansoni egg counts were performed. All patients were given oral ferrous sulfate before starting the experiment to raise their hemoglobin levels to over 10 gm %. The mean daily blood loss in the 7 patients with heavy hookworm infections was 64.8 ml and the mean iron loss was 18.7; but a mean of 7.7 of this iron was reabsorbed. In the 8 patients with bilharzial polyposis, blood loss averaged 13.1 ml and iron loss, 4.3 mg. In 4 patients, the amount of iron reabsorbed was not significant, in the remaining 4, it reached only 2 mg. The reabsorption of 40% of the iron initially lost in the upper gastrointestinal tract may explain the remarkable tolerance of Egyptian farmers to prolonged hookworm infections. The general iron deficiency anemia prevalent among patients with bilharzial polyposis is due in part to the loss of iron which is not reabsorbed.
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