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Intussusception due to Yersinia enterocolitica enterocolitis in a patient with beta-thalassemia
1Department of Pathology, Orlando Regional Medical Center, 1414 South Orange Ave, Orlando, FL 32806, USA. mghansen1@msn.com
Insights
Beta-thalassemia patients are susceptible to Yersinia enterocolitica infections due to iron overload from transfusions. This case highlights Yersinia causing intussusception via lymphoid hyperplasia in a child.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Hematology
Background:
- Homozygosity for beta-thalassemia major necessitates frequent blood transfusions.
- Blood transfusions can lead to iron overload, even with chelation therapy.
- Iron is a critical growth factor for Yersinia species.
Observation:
- A 4-year-old child with beta-thalassemia presented with intussusception of the terminal ileum.
- The patient had a history of monthly blood transfusions, contributing to an iron-overloaded state.
- Yersinia enterocolitica infection was identified as the causative agent.
Findings:
- Yersinia enterocolitica infection led to lymphoid hyperplasia and hypertrophied Peyer's patches in the ileum.
- This lymphoid hyperplasia caused a mass effect, resulting in intussusception.
- This represents the first reported case of Yersinia-induced intussusception.
Implications:
- Highlights a rare complication of Yersinia enterocolitica infection in iron-overloaded patients.
- Underscores the importance of considering Yersinia in the differential diagnosis of intussusception in thalassemia patients.
- Suggests potential links between iron metabolism, infection susceptibility, and gastrointestinal complications.
Abstract:
Patients who are homozygous for thalassemia major are at risk for Yersinia enterocolitica infections. We present a case of a 4-year-old child with intussusception of the terminal ileum whose past medical history was significant for beta-thalassemia. His monthly blood transfusions for this condition may have put him at risk for Y enterocolitica enterocolitis. The pathogenesis of this disease relates to the role of iron as an essential growth factor for Yersinia, and this patient's transfusions left him in an iron-overloaded state, despite treatment with Desferal. Our patient's unusual presentation of intussusception was secondary to the mass effect caused by lymphoid hyperplasia, specifically hypertrophied Peyer's patches in the ileum caused by Y enterocolitica infection. To our knowledge, this is the first such case of intussusception caused by Yersinia to be reported.