Glucose-6-phosphate deficiency: Difference between revisions
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==DDx== | ==DDx== | ||
==Management<ref>Schick P et al. eMedicine. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency Treatment & Management. Sep 29, 2015. http://emedicine.medscape.com/article/200390-treatment#showall</ref>== | |||
*Identify and discontinue precipitating agent | |||
*Supportive care for anemia, with transfusions rarely needed | |||
*Hemolysis usually self-limited, resolving within 8-14 days | |||
*Infants | |||
**Prolonged neonatal jaundice due to G6PD deficiency may require phototherapy | |||
**Exchange transfusion for severe neonatal jaundice | |||
==Precipitate and Avoid== | ==Precipitate and Avoid== | ||
*Infection | *Infection | ||
*Fava Beans | |||
*Medications | *Medications | ||
**Nitrofurantoin | **Nitrofurantoin | ||
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**Antimalarials | **Antimalarials | ||
**Sulfonamides | **Sulfonamides | ||
* | **Ciprofloxacin, norfloxacin | ||
**Methylene blue | |||
**Vitamin K analogues | |||
**NSAIDs | |||
==Alternative Antibiotics== | ==Alternative Antibiotics== | ||
Revision as of 21:44, 14 February 2016
Background
- X-Linked recessive; protects against Malaria
- African, Asian, and Mediterranean descent
- Nonimmune mediated hemolytic anemia
- Stress or drugs can cause hemoglobin precipitation within the RBC
- Leads to removal of the cell from circulation via the spleen
Clinical
- Fatigue
- Hemolytic anemia
- Jaundice
- Splenomegaly
Complications
- Severe hemolysis and anemia
- Cardiovascular collapse
Labs
- CBC
- Heinz Bodies
- Retic Count
- Retic count high
- Coombs negative: G6PD, SCD, spherocytosis, microangiopathic hemolysis
- Retic count high
DDx
Management[1]
- Identify and discontinue precipitating agent
- Supportive care for anemia, with transfusions rarely needed
- Hemolysis usually self-limited, resolving within 8-14 days
- Infants
- Prolonged neonatal jaundice due to G6PD deficiency may require phototherapy
- Exchange transfusion for severe neonatal jaundice
Precipitate and Avoid
- Infection
- Fava Beans
- Medications
- Nitrofurantoin
- Phenazopyridine
- Dapsone
- Chloramphenicol
- Antimalarials
- Sulfonamides
- Ciprofloxacin, norfloxacin
- Methylene blue
- Vitamin K analogues
- NSAIDs
Alternative Antibiotics
- Cephalexin (Keflex)
Also See
Source
- Tintinnalli, 7th edition, Chapter 231, “Sickle Cell and Other Hereditary Hemolytic Anemias,” accessed via Access Emergency Medicine
- ↑ Schick P et al. eMedicine. Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency Treatment & Management. Sep 29, 2015. http://emedicine.medscape.com/article/200390-treatment#showall