A 5-year-old child with hemolytic anemia caused by glucose-6-phosphate dehydrogenase deficiency: a case report

Abstract

Introduction: Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that plays an essential role in the human body cell. It is found in the cytoplasm of cells and functions to prevent cellular damage from reactive oxygen species. G6PD deficiency can be highly variable in its clinical presentation. It can cause acute or chronic hemolytic anemia and hyperbilirubinemia. Severe hemolytic can cause mortality in children. So, it is crucial to be aware during the diagnosis of hemolytic anemia at any age. The hemolytic occurred is usually precipitated by exposure to medication or intake of fava bean. This report is aimed to describe the diagnosis and treatment of a child who appears with acute hemolytic anemia due to favism.Case description: A 5-year-old boy came to the emergency department with a chief complaint of pale and fatigue since a day before admission in PKU Muhammadiyah Gamping Hospital. No family history of hemolytic anemia or parental consanguinity. He appeared icteric and with severe anemia. We found that he consumed fava beans twelve hours prior to the onset of the symptoms was reported. The laboratory findings were as follows: Hb 4.9 g/dl, total bilirubin 6.17 mg/dl, indirect bilirubin 5.49 mg/dl and a negative Coomb’s test result then obtained. The patient then is transfused with PRC, and the level of Hb became 9.2 g/dl and total bilirubin 0.2 mg/dl. The blood smear result was met hemolytic anemia and bacterial infection. The level of G6PD result obtained four days after was low, 7.5 U/gr Hb (10.0-14.2).Conclusion: The severe hemolytic anemia in the patient was proven caused by G6PD deficiency.