Sunday, February 15, 2015

Study group discussion: G6PD deficiency and Myoglobinuria

If a person has presents with hemolysis after ingestion of flava beans and dapsone, when will you ask to get G6PD levels?

Not during the hemolysis because G6PD will be normal when hemolysis is occuring. It's normal because the hemolysis causes release of G6PD in the plasma.

For how long would you wait to take a blood draw?
Around 2-3 weeks after the hemolysis episode.

Name the three classes of drugs that cause G6PD deficiency hemolysis:
Anti-pyretics like aspirin
Anti bacterials like sulfonamides and dapsone
Fava beans

I had seen a case of G6PD deficiency in my wards... An elderly patient who ate just some weird beans last night got dark coloured urine in the morning. It was a wonder he had never been sick before. We couldn't identify the beans though. They were not flava.

I have seen a similar presentation of a different disease. A case of myoglobinuria.. Cola coloured urine, an injury to the leg. She was kept on fluids and diuretics. She had crush syndrome.

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