Hookworm anaemia and intestinal malabsorption associated with hookworm infestation.

Abstract

Anaemia in hookworm infestation due to iron deficiency has been firmly established [1,2]. Blood loss in these patients [3–8] is associated quantitatively with hookworm load. Protein loss in patients with severe hookworm infestation may lower the total serum protein [6, 9]. Haemopoietic nutrients other than these, namely vitamin B12 and folic acid, however, need to be examined. A variable proportion of patients with hookworm disease have functional and structural changes of the small bowel leading to the clinical features of malabsorption [10–15]. Earlier studies have suggested that in humans, protein deficiency is related to abnormalities of small intestine function and structure [16, 17]. Reversal of malabsorption in cases with or without hookworm infestation on a high protein diet without any additional vitamin, antibiotic and without dewormification in the former has been demonstrated [17, 18]. It has also been postulated that vitamin B12 deficiency may either induce or aggravate the intestinal malabsorption [19]. The present communication comments on anaemia, haemopoietic nutrient deficiency and protein deficiency in patients with hookworm infestation. It also discusses the role of vitamin B12 and protein deficiency in the etiopathogenesis of intestinal malabsorption. Further, similar studies have been also carried out in patients without hookworm infestation and a comparison of the two has been made.