Crohn's disease and ulcerative colitis in β-thalassemia major: A report of two cases and a brief review of the literature.

The co-occurrence of β-thalassemia major and inflammatory bowel disease is exceedingly rare, yet clinically important, as overlapping manifestations such as severe anemia, fatigue, abdominal pain and dysentery may mask the underlying inflammatory bowel disease and delay diagnosis. The patients described in the present case report exhibited markedly elevated levels of inflammatory markers and fecal calprotectin levels (>1,000 µg/g); these findings, together with colonoscopic and histopathological findings, enabled the diagnosis of both major inflammatory bowel disease subtypes, namely Crohn's disease and ulcerative colitis. These cases add to the limited literature available by demonstrating that inflammatory bowel disease should be considered in patients with β-thalassemia major presenting with persistent gastrointestinal symptoms, particularly when symptoms are disproportionate to baseline disease manifestations. Early clinical suspicion, prompt diagnostic evaluation, and multidisciplinary management are crucial for preventing further clinical deterioration, minimizing complications and improving long-term outcomes. However, further studies are warranted to clarify the potential pathophysiological association and establish optimal management strategies for this rare coexistence.