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Most individuals with G6PD deficiency are asymptomatic.When it induces hemolysis, the effect is usually short-lived. [5]Most people who develop symptoms are male, due to the X-linked pattern of inheritance, but female carriers can be affected due to unfavorable lyonization or skewed X-inactivation, where random inactivation of an X-chromosome in certain cells creates a population of G6PD ...
Rasburicase administration can cause anaphylaxis (incidence unknown); methemoglobinemia may occur in susceptible individuals such as those with G6PDH deficiency due to the production of hydrogen peroxide in the urate oxidase reaction. [3] Testing patients for G6PDH deficiency prior to starting a course of rasburicase has been recommended. [3]
If drug-induced nonautoimmune hemolytic anemia occurs secondarily to drug induced methemoglobinemia, methylene blue can be used as a first-line therapy. However methylene blue should be avoided in those with a concomitant G6PD deficiency as methylene blue may cause further oxidative hemolysis.
G6PD reduces NADP + to NADPH while oxidizing glucose-6-phosphate. [2] Glucose-6-phosphate dehydrogenase is also an enzyme in the Entner–Doudoroff pathway, a type of glycolysis. Clinically, an X-linked genetic deficiency of G6PD makes a human prone to non-immune hemolytic anemia. [3]
NADPH deficiency can cause a dysfunction in glutathione peroxidase which is an enzyme that converts hydrogen peroxide (a reactive oxygen species) into water. G6PD (glucose-6-phosphate dehydrogenase) deficiency exacerbated by administration of oxidant drugs (e.g., primaquine, dapsone, quinidine) can also result in Heinz bodies. G6PD deficient ...
Genetically induced chronic low-level methemoglobinemia may be treated with oral methylene blue daily. Also, vitamin C can occasionally reduce cyanosis associated with chronic methemoglobinemia, and may be helpful in settings in which methylene blue is unavailable or contraindicated (e.g., in an individual with G6PD deficiency). [22]
Pegloticase is a PEGylated recombinant porcine-like uricase.Similarly to rasburicase, it metabolises uric acid to allantoin.This reduces the risk of urate precipitates, since allantoin is five to ten times more soluble than uric acid.
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