Hepatitis E virus is one of the leading causes of acute viral hepatitis in India but usually manifests as a mild self-limiting illness. Viral hepatitis in the presence of glucose-6-phosphate dehydrogenase (G6PD) deficiency may be associated with complications such as severe anemia, hemolysis, renal failure, hepatic encephalopathy and even death. The incidence of G6PD deficiency in the general population of northern India is reported to be between 2.2% and 14%. Despite both hepatitis E infection and G6PD deficiency being common, their impact on patient illness has only recently been reported. The present study reports a case of severe hemolysis in a patient with G6PD deficiency and hepatitis E infection.Key words: Glucose-6-phosphate dehydrogenase; G6PD; Hemolysis; Hepatitis E Exposé de cas : Hépatite E aiguë en présence d'un déficit en glucose-6-phosphate-déshy-drogénase Le virus de l'hépatite E est l'une des principales causes d'hépatite aiguë en Inde, mais il s'agit en général d'une maladie bénigne, spontanément résolutive. Par contre, une hépatite virale en présence d'un déficit en glucose-6-phosphate-déshydrogénase (G6PD) peut donner lieu à des complications comme une anémie grave, l'hémolyse, l'insuffisance rénale, une encéphalopathie porto-cave et même la mort. L'incidence du déficit en G6PD dans la population en général dans le Nord de l'Inde varie entre 2,2 et 14 %. Même si l'hépatite E et le déficit en G6PD sont deux affections fréquentes, on ne fait état de leur influence sur l'évolution de la maladie que depuis peu. Voici un cas d'hémolyse grave chez un patient atteint à la fois d'un déficit en G6PD et d'une hépatite E.H epatitis E is an enterically transmitted virus and is one of the most common causes of acute viral hepatitis in India (1). Glucose-6-phosphate dehydrogenase (G6PD) deficiency is found in 2.2% to 14% of the general population in North India (2). The coexistence of viral hepatitis and G6PD deficiency has been reported to be associated with severe jaundice and other complications (3,4). Hepatitis E infection with G6PD deficiency has been associated with more severe illness in only one previous report (5). We report an additional case. CASE REPORTA 35-year-old man with no history of alcoholism or liver disease presented with low grade fever, upper abdominal pain, fatigue and loss of appetite for eight to 10 days. He had noticed a yellow discolouration of the eyes for three days and dark coloured urine for five to six days. On examination, he was deeply icteric. Abdominal examination revealed a soft, tender liver, palpable 4 cm below the costal margin. There was no splenomegaly and the remainder of the physical examination was normal.Laboratory investigations revealed a hemoglobin mass concentration of 126 g/L, a total leucocyte count of 12.2x10 9 /L, and a total serum bilirubin of 198 µmol/L with a conjugated fraction of 141 µmol/L. The serum aspartate aminotransferase (AST) concentration was 376 U/L and the alanine aminotransferase (ALT) concentration was 270 U/L. The prothrombin time wa...

An evaluation was made of the diagnostic efficacy and utility of the Parasight-F test in diagnosing Plasmodium falciparum malaria, compared with conventional microscopy, particularly in severe and complicated cases. This study was designed as a prospective, case control hospital-based study. Febrile patients suspected to be suffering from malaria were selected randomly and were subjected to peripheral smear examinations (thick and thin) and Parasight-F tests till the required number of at least 30 cases of P. falciparum infection were identified, including at least 15 complicated cases. In addition 20 cases of P. vivax malarial infection as well as 20 healthy age and sex-matched individuals were taken as two control groups. The outcome measure was the number of cases with positive Parasight-F test results compared with conventional microscopy. Thirty-two patients with P. falciparum malaria were identified, with 15 severe and complicated cases. Peripheral smears were positive in 29 (91%) of these, while parasight-F test was positive in 31 out of 32 (97%) cases. Parasites were detected only by bone marrow examination in one case. Diagnostic sensitivity and specificity of peripheral smears for detecting falciparum infection were 90.6% and 100% respectively while that of the Parasight-F test were 96.8% and 100%, respectively (P>.05). The Parasight-F test has high sensitivity and specificity in diagnosing P. falciparum malarial infection, comparable to or even higher than microscopy exams, particularly in severe and complicated cases, with additional advantages of speed, simplicity and objectivity.

No abstract

No abstract

No abstract