Use caution with G6PD deficiency
, sickle-cell anemia, or high levels of unbound iron or copper, although large doses of vitamin E may help against hemolysis.
Renilyn Reyes, DOH-6 Family and Nutrition Cluster Head, said that G6PD deficiency
is the most common enzyme deficiency worldwide.
According to Sachdev, the treatment procedure had to be changed as tests revealed that the patient suffered from G6PD deficiency
hereditary spherocytosis, G6PD deficiency
, pyruvate kinase deficiency or Rh/ABO hemolytic disease).
Methemoglobinemia may also arise in patients with congenital G6PD deficiency
, but this occurs infrequently because the enzyme plays a minor role in maintaining the reduction state of hemoglobin compared to b5-Met-Hb reductase (2).
In the rare event that the patient's status worsens after methylene blue administration, G6PD deficiency
should be strongly suspected.
Inherited blood disorders, such as sickle cell disease, the G6PD deficiency
and Thalassaemia, are among the most challenging public health issues for the Omani authorities, particularly for the Ministry of Health.
Quinine-induced haemolytic anaemia has been reported in patients with G6PD deficiency
, and cardiac arrhythmia in patients who are elderly or have pre-existing cardiovascular disease.
45] However, with increasing immigration from other parts of Africa, the demographics of G6PD deficiency
may have changed.
I would like to add to this well written article that we have also reported acquired methemoglobinemia cases with administration of cytanest in puerperal women with G6PD deficiency
and infants in whom erythrocyte cytochrome 65 reductase was assoyed (1-4), which is the main enzyme for methemoglobin reductase in erythrocytes as mentioned by the authors.
Major risk factors include a high-risk zone total serum-bilirubin level; jaundice within the first 24 hours; gestational age of 35 weeks to 36 weeks; previous sibling to have received phototherapy; significant bruising; exclusive breastfeeding; East Asian race; and blood-group incompatibility or other known hemolytic disease such as G6PD deficiency
The most common genetic disorders seen in the region are thalassaemia, sickle cell disease, G6PD deficiency
, chromosomal deficiency and Down's Syndrome.