Which clinical history findings are characteristic of glucose-6-phosphate dehydrogenase (G6PD) deficiency-related acute hemolytic anemia?

Updated: Jun 25, 2020
  • Author: Lawrence C Wolfe, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Acute episodic hemolytic anemia occurs on exposure to oxidative stress, as in association with certain medications and chemicals, infections, and ketoacidosis, and after ingestion of fava beans. Hemolysis usually begins 24-72 hours after exposure to oxidative stress. In cases of severe hemolysis, patients present with malaise, irritability, weakness, jaundice, tachycardia due to moderate to severe anemia, and often dark urine (cola- or tea-colored) due to hemoglobinuria (usually within 6-24 hours). The onset can be extremely abrupt, especially with favism in children.

Acute hemolysis is usually self-limited and resolves within 8-14 days due to the compensatory production of young red blood cells, which have high levels of G6PD enzyme. Young red blood cells are not vulnerable to oxidative damage and, hence, limit the duration of hemolysis. Acute renal failure is a rare complication of acute hemolytic anemia in adults. [4, 18]


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