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Favism: Clinical Features at Different Ages. Nutrients 2023; 15:nu15020343. [PMID: 36678214 PMCID: PMC9864644 DOI: 10.3390/nu15020343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
Favism is a hemolytic disease due to the ingestion of fava beans in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. There is wide inter- and intra-individual variability in the development of hemolytic crisis, and several factors influence it: quantity, quality, ripeness of fava beans, and age of onset. In this narrative review of case reports and case series, we reported the predisposing factors and clinical features for four different age groups classified as follows: pregnant women and infants (i.e., exclusively breastfed children); children, from weaned to 11 years; preadolescents and adolescents, from 11 to 18 years; and adults (18 years and older). Some symptoms developed only in specific age groups: death in infants; visual impairment in children; systolic murmur in infants, children, and adolescents; and renal failure in adults. In youngest children or pregnant women the severity is the highest. Some other symptoms were present in all: jaundice, increased bilirubin, splenomegaly, hepatomegaly, discolored urine, tachycardia, pallor, abdominal pain, malaise, vomit, nausea, and dizziness. Laboratory findings are characterized by anemia, reticulocytosis, elevated bilirubin level, and sometimes urinary urobilinogen and methemoglobinemia. In most cases the symptomatology is self-limited and does not release sequelae, but hospitalization and transfusion are often required.
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Lee HY, Ithnin A, Azma RZ, Othman A, Salvador A, Cheah FC. Glucose-6-Phosphate Dehydrogenase Deficiency and Neonatal Hyperbilirubinemia: Insights on Pathophysiology, Diagnosis, and Gene Variants in Disease Heterogeneity. Front Pediatr 2022; 10:875877. [PMID: 35685917 PMCID: PMC9170901 DOI: 10.3389/fped.2022.875877] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/02/2022] [Indexed: 01/04/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a prevalent condition worldwide and is caused by loss-of-function mutations in the G6PD gene. Individuals with deficiency are more susceptible to oxidative stress which leads to the classical, acute hemolytic anemia (favism). However, G6PD deficiency in newborn infants presents with an increased risk of hyperbilirubinemia, that may rapidly escalate to result in bilirubin induced neurologic dysfunction (BIND). Often with no overt signs of hemolysis, G6PD deficiency in the neonatal period appears to be different in the pathophysiology from favism. This review discusses and compares the mechanistic pathways involved in these two clinical presentations of this enzyme disorder. In contrast to the membrane disruption of red blood cells and Heinz bodies formation in favism, G6PD deficiency causing jaundice is perhaps attributed to the disruption of oxidant-antioxidant balance, impaired recycling of peroxiredoxin 2, thus affecting bilirubin clearance. Screening for G6PD deficiency and close monitoring of affected infants are important aspects in neonatal care to prevent kernicterus, a permanent and devastating neurological damage. WHO recommends screening for G6PD activity of all infants in countries with high prevalence of this deficiency. The traditional fluorescent spot test as a screening tool, although low in cost, misses a significant proportion of cases with moderate deficiency or the partially deficient, heterozygote females. Some newer and emerging laboratory tests and diagnostic methods will be discussed while developments in genomics and proteomics contribute to increasing studies that spatially profile genetic mutations within the protein structure that could predict their functional and structural effects. In this review, several known variants of G6PD are highlighted based on the location of the mutation and amino acid replacement. These could provide insights on why some variants may cause a higher degree of phenotypic severity compared to others. Further studies are needed to elucidate the predisposition of some variants toward certain clinical manifestations, particularly neonatal hyperbilirubinemia, and how some variants increase in severity when co-inherited with other blood- or bilirubin-related genetic disorders.
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Affiliation(s)
- Heng Yang Lee
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Azlin Ithnin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Raja Zahratul Azma
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
| | - Ainoon Othman
- Department of Medical Science II, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Armindo Salvador
- CNC-Centre for Neuroscience Cell Biology, University of Coimbra, Coimbra, Portugal.,Coimbra Chemistry Centre-Institute of Molecular Sciences (CQC-IMS), University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Fook Choe Cheah
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia
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Garcia AA, Koperniku A, Ferreira JCB, Mochly-Rosen D. Treatment strategies for glucose-6-phosphate dehydrogenase deficiency: past and future perspectives. Trends Pharmacol Sci 2021; 42:829-844. [PMID: 34389161 DOI: 10.1016/j.tips.2021.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/19/2021] [Accepted: 07/13/2021] [Indexed: 01/20/2023]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) maintains redox balance in a variety of cell types and is essential for erythrocyte resistance to oxidative stress. G6PD deficiency, caused by mutations in the G6PD gene, is present in ~400 million people worldwide, and can cause acute hemolytic anemia. Currently, there are no therapeutics for G6PD deficiency. We discuss the role of G6PD in hemolytic and nonhemolytic disorders, treatment strategies attempted over the years, and potential reasons for their failure. We also discuss potential pharmacological pathways, including glutathione (GSH) metabolism, compensatory NADPH production routes, transcriptional upregulation of the G6PD gene, highlighting potential drug targets. The needs and opportunities described here may motivate the development of a therapeutic for hematological and other chronic diseases associated with G6PD deficiency.
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Affiliation(s)
- Adriana A Garcia
- Department of Chemical and Systems Biology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Ana Koperniku
- Department of Chemical and Systems Biology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Julio C B Ferreira
- Department of Chemical and Systems Biology, School of Medicine, Stanford University, Stanford, CA, USA; Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Daria Mochly-Rosen
- Department of Chemical and Systems Biology, School of Medicine, Stanford University, Stanford, CA, USA.
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Roper D, Layton M, Rees D, Lambert C, Vulliamy T, De la Salle B, D’Souza C. Laboratory diagnosis of G6PD deficiency. A British Society for Haematology Guideline. Br J Haematol 2020; 189:24-38. [DOI: 10.1111/bjh.16366] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- David Roper
- Department of Haematology Imperial College Healthcare NHS Trust London UK
| | - Mark Layton
- Department of Haematology Imperial College Healthcare NHS Trust London UK
| | - David Rees
- Department of Haematology King's College Hospital NHS Foundation Trust London UK
| | - Chris Lambert
- Department of Haematology and Blood Transfusion King's College Hospital NHS Foundation Trust London UK
| | - Tom Vulliamy
- Queen Mary University of London Blizard Institute London UK
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Saito M, Gilder ME, McGready R, Nosten F. Antimalarial drugs for treating and preventing malaria in pregnant and lactating women. Expert Opin Drug Saf 2018; 17:1129-1144. [PMID: 30351243 DOI: 10.1080/14740338.2018.1535593] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Malaria in pregnancy and postpartum cause maternal mortality and adverse fetal outcomes. Efficacious and safe antimalarials are needed to treat and prevent such serious consequences. However, because of the lack of evidence on fetal safety, quinine, an old and less efficacious drug has long been recommended for pregnant women. Uncertainty about safety in relation to breastfeeding leads to withholding of efficacious treatments postpartum or cessation of breastfeeding. Areas covered: A search identified literature on humans in three databases (MEDLINE, Embase and Global health) using pregnancy or lactation, and the names of antimalarial drugs as search terms. Adverse reactions to the mother, fetus or breastfed infant were summarized together with efficacies. Expert opinion: Artemisinins are more efficacious and well-tolerated than quinine in pregnancy. Furthermore, the risks of miscarriage, stillbirth or congenital abnormality were not higher in pregnancies exposed to artemisinin derivatives for treatment of malaria than in pregnancies exposed to quinine or in the comparable background population unexposed to any antimalarials, and this was true for treatment in any trimester. Assessment of safety and efficacy of antimalarials including dose optimization for pregnant women is incomplete. Resistance to sulfadoxine-pyrimethamine in Plasmodium falciparum and long unprotected intervals between intermittent treatment doses begs reconsideration of current preventative recommendations in pregnancy. Data remain limited on antimalarials during breastfeeding; while most first-line drugs appear safe, further research is needed.
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Affiliation(s)
- Makoto Saito
- a Shoklo Malaria Research Unit (SMRU), Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Tak , Thailand.,b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine , University of Oxford , Oxford , UK.,c WorldWide Antimalarial Resistance Network (WWARN) , Oxford , UK
| | - Mary Ellen Gilder
- a Shoklo Malaria Research Unit (SMRU), Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Tak , Thailand
| | - Rose McGready
- a Shoklo Malaria Research Unit (SMRU), Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Tak , Thailand.,b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine , University of Oxford , Oxford , UK
| | - François Nosten
- a Shoklo Malaria Research Unit (SMRU), Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Tak , Thailand.,b Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine , University of Oxford , Oxford , UK
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Keller CC, Joosten M, Middeldorp AM, Knapen MFCM. Fetal anemia caused by the Guadalajara variant of G6PD deficiency. Prenat Diagn 2015; 35:1255-7. [PMID: 26279483 DOI: 10.1002/pd.4677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/16/2015] [Accepted: 08/12/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Caroline C Keller
- Department of Obstetrics and Prenatal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Marieke Joosten
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - Maarten F C M Knapen
- Department of Obstetrics and Prenatal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands.,Stichting Prenatale Screening Zuidwest Nederland, Rotterdam, the Netherlands
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Molad M, Waisman D, Rotschild A, Auslander R, Kessel I, Soloviechick M, Goldberg Y, Shabad E. Nonimmune hydrops fetalis caused by G6PD deficiency hemolytic crisis and congenital dyserythropoietic anemia. J Perinatol 2013; 33:490-1. [PMID: 23719252 DOI: 10.1038/jp.2012.116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present a case of a female neonate who had a nonimmune hydrops fetalis and severe hemolytic anemia due to a rare combination of glucose-6-phosphate dehydrogenase (G6PD) deficiency and congenital dyserythropoietic anemia. We conclude that in severe cases with persistent anemia one should search after delivery for a second reason other than G6PD deficiency alone.
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Affiliation(s)
- M Molad
- Department of Neonatology, Carmel Medical Center and Faculty of Medicine, Technion-ITT, Haifa, Israel
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Zhang EG, Regan F, Layton M, Paramasivam G, Wyatt-Ashmead J, Roberts I, Kumar S. Managing the difficult case of fetal anemia. J Matern Fetal Neonatal Med 2011; 24:1498-503. [PMID: 21714692 DOI: 10.3109/14767058.2010.551149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To describe a series of complex fetal anemia cases, detail the appropriate investigations and management, and review the literature. METHODS Four cases of non-red cell alloimmunization or infective cases of fetal anemia are presented. RESULTS Of the four cases presented, one was a neonatal death, one pregnancy was terminated, one case was diagnosed with Diamond Blackfan anemia, and one case was due to recurrent feto-maternal hemorrhages despite negative Kleihauer tests. CONCLUSIONS Non-alloimmune causes of fetal anemia can be difficult to manage. Some cases require repeated and frequent intrauterine transfusions. The perinatal mortality and preterm delivery rates are increased, and some cases require considerable long-term treatment including regular transfusions. We present our experience of a series of non-immune fetal anemia managed in a tertiary unit, review the literature, and suggest appropriate management.
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Affiliation(s)
- Eko G Zhang
- Centre for Fetal and Maternal Medicine, Queen Charlotte's and Chelsea Hospital, Imperial College London , London, UK
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9
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Abstract
Anemia is a commonly encountered problem in the fetal and neonatal period, and can lead to significant morbidity and mortality. Intrinsic disorders of the erythrocyte, such as the hemoglobinopathies, enzyme deficiencies, and membrane defects are common causes of neonatal anemia. Genetic diseases that lead to decreased erythrocyte production, such as Diamond-Blackfan anemia, Schwachman-Diamond syndrome, and Congential Dyserythropoietic Anemia, are rare causes of perinatal anemia, but are important to recognize as they are often associated with other congenital abnormalities and require specialized treatment. This review focuses on the perinatal presentation and management of intrinsic erythrocyte disorders, as well as on the diagnosis and management of genetic conditions leading to erythrocyte underproduction.
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Affiliation(s)
- Laurie A Steiner
- Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA.
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10
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Abstract
Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, a commonly occurring enzymatic defect, is an important risk factor in the pathogenesis of severe neonatal hyperbilirubinemia. Many of the recently reported cases of kernicterus, even in countries with a low overall incidence of the G-6-PD deficiency such as the United States and Canada, have been found to be enzyme deficient. In many cases the hyperbilirubinemia may be due to acute hemolysis precipitated by exposure to an identifiable chemical trigger, or to infection. In other cases the hemolysis may be mild, the hyperbilirubinemia being due to diminished bilirubin conjugation. An interaction between G-6-PD deficiency and promoter polymorphism for the gene encoding the bilirubin conjugating enzyme, UDP-glucuronosyltranferase 1A1, associated with Gilbert syndrome, has been implicated in the pathogenesis of hyperbilirubinemia. Neonates whose families originated in areas at high risk for G-6-PD deficiency should be vigilantly observed for jaundice. Phototherapy is the mainstay of treatment, with exchange transfusion being performed in those unresponsive to phototherapy. A high degree of physician awareness is essential in the identification and follow-up of these high-risk neonates.
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Affiliation(s)
- Michael Kaplan
- Department of Neonatology, Shaare Zedek Medical Center, Jerusalem.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize recently published studies on noninvasive diagnosis of fetal anemia in order to give recommendations for the use of these new tools. RECENT FINDINGS Red cell alloimmunization remains one of the most common causes of fetal anemia. Amniocentesis and cordocentesis have been used for many years to diagnose fetal anemia due to red cell aloimmunization. These techniques, however, are invasive and many complications are associated with their use. Noninvasive diagnosis of fetal anemia has been performed with Doppler ultrasonography. Based on robust data, several authors recommend the use of middle cerebral artery peak systolic velocity in the management of fetuses at risk for anemia because of red cell alloimmunization. This Doppler parameter can also diagnose fetal anemia due to other conditions. SUMMARY Middle cerebral artery peak systolic velocity appears to be the best test for the noninvasive diagnosis of fetal anemia. It is important to emphasize that training of sonographers and sonologists is the 'conditio sine qua non' for the correct sampling of the middle cerebral artery.
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Affiliation(s)
- Maria Segata
- Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio 45267, USA
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12
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Abstract
Vitamin metabolism and requirements are reviewed for the micropremie (1000 Pounds g birthweight), for parenteral and enteral feedings. Recommendations are presented in table format. Human milk fortifiers and special formulas for the preterm infant are reviewed. For parenteral nutrition, only MVI Pediatric is currently available in the United States. Two millimeters per kilogram is recommended for the micropremie as the most satisfactory method of providing supplemental vitamins in total parenteral nutrition solutions.
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Affiliation(s)
- F R Greer
- Department of Pediatrics, University of Wisconsin, Madison, USA
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13
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Abstract
The causes of hydrops fetalis are myriad. As a result of the advent of routine Rh screening, most cases are not currently related to Rh incompatibility. Genetic, metabolic, chromosomal, and syndromic causes are among the most frequently identified causes of nonimmune hydrops. The importance of determining the underlying cause of hydrops becomes evident once issues such as prognosis, specific treatment, and risk of recurrence are considered. The medical geneticist is highly qualified to assist in the evaluation of hydrops. Clinical geneticists have undergone training in a primary care specialty followed by intensive training in the diagnosis, management, and counseling of individuals and families with genetic, chromosomal, or multifactorial syndromes or birth defects. This training prepares the medical geneticist well to serve as a consultant when hydrops is diagnosed. As knowledge of the molecular genetic and metabolic basis of disease increases, utilization of genetics laboratories continues to increase dramatically. In addition to examining the child to look for dysmorphic features, the clinical geneticist can assist with the laboratory evaluation by coordinating testing with the cytogeneticist, molecular geneticist, and biochemical geneticist as appropriate. Increased awareness of the role of the geneticist in the evaluation of such patients should prove helpful to the physicians caring for such patients and the patients' families.
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Affiliation(s)
- R D Steiner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
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Abstract
Hematologic disorders are implicated in approximately 10% to 27% of cases of nonimmune hydrops fetalis. In almost all of these disorders, anemia leading to heart failure, edema, ascites, and anasarca is the final common denominator. The etiology of the anemia in these cases can be conveniently divided into two categories: (1) excessive erythrocyte loss by hemolysis or hemorrhage, and (2) erythrocyte underproduction. The former include intrinsic erythrocyte abnormalities such as alpha-thalassemia and glucose-6-phosphate dehydrogenase deficiency, and conditions with excessive fetal blood loss such as fetomaternal hemorrhage and twin-twin transfusion. The latter include bone marrow replacement syndromes and conditions associated with failure of erythrocyte production. The presentation, diagnosis, and management of hematologic disorders associated with nonimmune hydrops fetalis are reviewed.
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Affiliation(s)
- M O Arcasoy
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
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Abstract
BACKGROUND Antenatal manifestation of glucose-6-phosphate dehydrogenase deficiency is uncommon. CASE REPORT A male was born by caesarian section at 34 weeks of GA for hydrops fetalis (HF). Fetal ultrasonography showed hydrops fetalis for the first time at 24 weeks of GA. All investigations were normal, except moderate anemia (Hb: 11.5 g/dl) and important erythroblastosis (67%) in the fetal blood sampling at 25 weeks. HF spontaneously resolved, until caesarian section at 34 weeks for recurrence of HF. Hydrops and neonatal anemia were successfully treated with pleural and peritoneal aspiration and blood transfusion. At the age of 4 months, investigations showed low levels of G-6-PD activity. At the age of 12 months, the child's growth and development appeared to be appropriate. CONCLUSIONS Diagnosis of G-6-PD deficiency must be suspected when HF due to anemia occurs in a population at risk; it could be confirmed by an enzyme study of fetal red blood cells.
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Affiliation(s)
- P Masson
- Service de soins intensifs néonatals et pédiatriques, hôpital Victor-Fouche, centre hospitalier régional et universitaire, Fort-de-France, France
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Valaes T. Severe neonatal jaundice associated with glucose-6-phosphate dehydrogenase deficiency: pathogenesis and global epidemiology. ACTA PAEDIATRICA (OSLO, NORWAY : 1992). SUPPLEMENT 1994; 394:58-76. [PMID: 7919613 DOI: 10.1111/j.1651-2227.1994.tb13216.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The association of glucose-6-phosphate dehydrogenase deficiency (G6PD def) with severe neonatal jaundice (NJ) and Kernicterus was described just over 30 years ago in reports from Sardinia (1-4) Singapore (5,6) and Greece (7,8). In this review we will examine the progress made since that time in our understanding of the pathophysiology of severe NJ associated with G6PD def, its global epidemiology, and its role in the balanced polymorphism of the G6PD def gene (Gd). Including this review in the Festschrift to Spyros Doxiadis should highlight his contribution to the field. In Greece the search for a new cause of severe NJ and Kernicterus was triggered by his realization that the recognized at the time, causes of severe NJ were absent in a large proportion of the neonates treated at the "Alexandra" Maternity Hospital in Athens (9).
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Affiliation(s)
- T Valaes
- Department of Pediatrics, Tufts University School of Medicine, Boston, Massachusetts
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Samuels P, Ludmir J. Nonimmune hydrops fetalis: a heterogeneous disorder and therapeutic challenge. Semin Roentgenol 1990; 25:353-60. [PMID: 2237479 DOI: 10.1016/0037-198x(90)90066-d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- P Samuels
- Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia 19104
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Ravindranath Y, Paglia DE, Warrier I, Valentine W, Nakatani M, Brockway RA. Glucose phosphate isomerase deficiency as a cause of hydrops fetalis. N Engl J Med 1987; 316:258-61. [PMID: 3796702 DOI: 10.1056/nejm198701293160506] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
MESH Headings
- Anemia, Hemolytic, Congenital/blood
- Anemia, Hemolytic, Congenital/etiology
- Anemia, Hemolytic, Congenital/therapy
- Anemia, Hemolytic, Congenital Nonspherocytic
- Child, Preschool
- Edema/etiology
- Edema/therapy
- Exchange Transfusion, Whole Blood
- Female
- Fetal Diseases/etiology
- Humans
- Infant, Newborn
- Pregnancy
- Splenectomy
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Abstract
Excluding those with congenital syphilis all infants born in a hospital in South Korea with hydrops fetalis during a 47 month period were studied. In six out of a total of 17 cases no obvious abnormality was found. Abnormalities in the other cases included leukaemia, pulmonary cysts, ovarian cyst, haemangioma, peritonitis, limb contractures, left hypoplasia and maternal anaemia. The literature is reviewed and the pathophysiology discussed.
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Abstract
Apart from isoimmunization, a number of conditions may present as hydrops fetalis and now account for a large proportion of hydropic infants. A large differential diagnosis must be considered when investigating the hydropic fetus and placenta while in utero, in the neonatal period, and at autopsy. An investigative protocol is proposed.
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Abstract
Erythrocyte metabolic abnormalities should be considered as a possible cause of hemolysis when there is no evidence of an immune-mediated hemolytic anemia, no consumptive red blood cell disorder, no morophologic or laboratory data to suggest a problem of the red cell membrane, and no evidence of a quantitative or qualitative defect in hemoglobin synthesis. Glucose-6-phosphate dehydrogenase deficiency is clearly the most common enzyme deficiency causing clinical problems.
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Shturman-Ellstein R, Greco MA, Myrie C, Goldman EK. Hydrops fetalis, hydramnios and hepatic vascular malformation associated with cutaneous hemangioma and chorioangioma. ACTA PAEDIATRICA SCANDINAVICA 1978; 67:239-43. [PMID: 343490 DOI: 10.1111/j.1651-2227.1978.tb16311.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A premature baby presented with severe hydrops fetalis due to a multifocal angiomatous malformation of the liver. There were two other small vascular tumors: hemangioma of the skin and chorioangioma. Hydramnios and placental edema were also present. The association of severe hydrops fetalis and hydramnios with angiomatous malformation of the liver was not found in reviewing the literature.
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