Wednesday, 22 August 2007

G6PD Deficiency

My colleague who was admitted to the hospital is back to work. And he told us that he have G6PD deficiency. Do you know what G6PD Deficiency is? Here is some info about it.

Extract from G6PD Deficiency FAVISM Association

What is G6PD Deficiency (and its severe case called Favism)?

G6PD Deficiency is a hereditary abnormality in the activity of an erythrocyte (red blood cell) enzyme. This enzyme, glucose-6-phosphate dehydrogenase (G-6-PD), is essential for assuring a normal life span for red blood cells, and for oxidizing processes. This enzyme deficiency may provoke the sudden destruction of red blood cells and lead to hemolytic anemia with jaundice following the intake of fava beans, certain legumes and various drugs (see a complete list of drugs and foodstuffs to avoid).

The defect is sex-linked, transmitted from mother (usually a healthy carrier) to son (or daughter, who would be a healthy carrier too; see a diagram of inheritance probabilities). This is due to the fact that the structure of G-6-PD is carried on the X chromosome: As stated by Ernest Beutler, M.D., "in females, only one of the two X chromosomes in each cell is active; consequently, female heterozygotes for G-6-PD deficiency have two populations of red cells; deficient cells and normal cells."

The deficit is most prevalent in Africa (affecting up to 20% of the population), but is common also around the Mediterranean (4% - 30%) and southeast Asia. Please note that there are more than 400 genetic variants of the deficiency. You can determine whether you are G-6-PD deficient by a simple blood test. To determine your variant, you must test yourself at specialized genetic labs.


The symptoms
  • Sudden rise of body temperature and yellow coloring of skin and mucous membrane.
  • Dark yellow-orange urine.
  • Pallor, fatigue, general deterioration of physical conditions.
  • Heavy, fast breathing.
  • Weak, rapid pulse.

Risks

With G-6-PD deficiency you can have a perfectly normal life, provided you avoid the drugs and foodstuffs included in our To Avoid list. It is therefore of great importance to learn whether you or your baby suffer from the deficiency, so that you can watch your diet and drug intake, and warn your physician or pediatrician.

What to do in case of hemolytic crisis

Upon detecting the symptoms listed above, you should either call your physician or pediatrician, or go directly to the nearest hospital. Avoid the intake of any drugs. You would most probably be requested to list all foodstuffs and drugs taken in the preceding 48 hours, so try to recall and list them.

Tips for parents

Any boy suffering from Favism should be informed of his deficiency so he can help himself avoid the intake of the forbidden foodstuff in various situations where he is not under your supervision (such as school). You should also inform school supervisors and, where applicable, also the school caterers who provide school lunch. Best is to carry with you the To Avoid list and show it to all those who may treat your boy.

Can it be cured

The best therapy is simply to avoid the prohibited drugs and foodstuffs. In case of a hemolytic crisis, the most effective therapy is blood transfusion. In milder cases of the deficiency, transfusion is usually not required. But in others, where the rate of hemolysis is very rapid (as in all persons suffering from Favism), "transfusions of whole blood or packed cells may be useful" (Ernest Beutler, MD). In areas where G-6-PD deficiency is common, care must be taken to avoid giving G-6-PD deficient blood to the patient.

3 comments:

Apple said...

Yes Richard I know what is G6PD deficiency... Hehe... of cos la I am working in the paeds le... Usually we provide explanations and give leaflets to parents if their children have been diagnosed as having G6PD deficiency.
Poor thing le...Your friend must have encountered hemolysis of his RBCs due to exposure to some drugs or food that he or she should avoid.
You know, I always feel bad for babies who have G6PD deficiency cos that is for life. They will have to be well taken care of and when they grow up, they should be told by their parents what to avoid to prevent lysis of their precious RBCs.
So we must always treasure life and be happy that we are healthy enough to carry out our daily activities :)

Little Nutbrown Hare said...

Richard, I am glad and actually quite surprised to see that you have included health information in your blog. You know G6PD is my favourite topic of all time and I gave health teaching during my attachment in Singapore in NUH. Keep it up! :p

Richard From Brunei said...

I normally put anything in this blog that interest me :) So don't be surprise if u see me posting about plastic surgery..hehe.

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