G6PD deficiency

Mediterranean and Asian genetics
Etiology X linked recessive inheritance. Most common RBC enzyme defect. Protective against malaria.
Epidemiology
Clinical presentation gallstones, splenomegaly
Pathogenesis ↓ G6PD = ↓ glutathione = ↑ susceptibility to oxidative stress
Diagnostic investigations FBC: intravascular haemolysis
Blood film: Heinz bodies (due to oxidative damage), bite cells (damaged cells are less flexible)
Management

drugs to avoid

  • anti-malarials: primaquine
  • ciprofloxacin
  • sulph- group drugs: sulphonamides, sulphasalazine, sulfonylureas
  • dapsone