Aspirin-Induced Acute Haemolytic Anaemia in Glucose-6-Phosphate Dehydrogenase-Def icient Children with Systemic Arthritis

Meloni, T; Fórteleoni, G; Ogana, Augusto

doi:10.1159/000205562

Cited by 27 publications

(45 citation statements)

References 6 publications

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“…These findings are in consistent with those of some other researchers of different countries [14][15][16] . On the contrary, no remarkable change in osmotic fragility of RBC and red cell indices were reported.…”

Section: Discussionsupporting

confidence: 94%

“…On the contrary, no remarkable change in osmotic fragility of RBC and red cell indices were reported. 15,23 .…”

Section: Discussionmentioning

confidence: 99%

“…Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) may also decrease in this group of hemolytic anemic patients 15,16 .…”

Section: Introductionmentioning

confidence: 99%

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Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Sultana¹,

Begum

et al. 2009

Bangabandhu Sheikh Mujib Medical University Journal

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Abstract:Background: Vitamin E has role in maintaining the integrity of red cell membrane by preventing oxidation of polyunsaturated fatty acids and thereby protects cells from oxidative stress-induced lysis in G6PD deficiency, which can be reflected by changes in osmotic fragility of RBC and some absolute values like MCV, MCH & MCHC. Objective: To observe the effects of vitamin E supplementation on fragility of RBC in order to evaluate role of this antioxidant vitamin in reducing chronic hemolysis in G6PD deficient patients. Methods: For this, a total number of 102 subjects with age ranged from 5 to 40 years of both sexes were included in the study. Among them 68 were G6PD enzyme deficient patients, of whom 34 were in supplemented group (study group) and 34 were in non-supplemented group (control group). The supplemented group received vitamin E supplementation for 60 consecutive days at a dose of 800 IU/day for adult and 400 IU/day for children < 12 years (in a divided dose i,e. 4 times daily). Age and sex matched 34 apparently healthy subjects with normal blood G6PD level were taken to observe the base line data (healthy control) and also for comparison. All the G6PD deficient patients were selected from Out Patient Department (OPD) of Hematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2005 to June 2006 and all the healthy subjects were selected from personal contact. Blood G6PD level, osmotic fragility of RBC were measured by standard techniques and MCV, MCH, and MCHC were obtained by calculation. All the parameters were measured on day 1 (one) of their first visit and also were on day 60 in deficient group. Data were compared among the deficient groups, also in supplemented group just before and after supplementation. Analysis of data was done by appropriate statistical method. Results: Mean starting and completing points of osmotic fragility of RBC were significantly higher but MCV, MCH, MCHC were significantly lower in patients suffering from hemolytic anemia due to G6PD deficiency in comparison to those of the healthy control. After supplementation with vitamin E starting and completing points of osmotic fragility of RBC were significantly decreased whereas, MCV, MCH, MCHC were significantly increased towards those of healthy control in supplemented group of patients in comparison to those of their pre-supplemented (day-1) and non-supplemented groups both on day 1 and day 60. Conclusion: From this study it may be concluded that, disturbances of some of the hematological parameter like higher osmotic fragility of RBC and lower MCV, MCH, MCHC occur in G6PD deficient hemolytic anemic patients, which returned towards normal after supplementation of vitamin E, which clearly indicates the role of this anti-oxidant vitamin in maintaining red cell membrane integrity and thereby decreases the rate of hemolysis in this group of patients. So, vitamin E can be supplemented along with other drugs for better management of the patients.

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Section: Discussionsupporting

confidence: 94%

“…On the contrary, no remarkable change in osmotic fragility of RBC and red cell indices were reported. 15,23 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Sultana¹,

Begum

et al. 2009

Bangabandhu Sheikh Mujib Medical University Journal

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“…Moreover, several drugs that have been shown to have a minor effect on red cell survival, such as aspirin, when given in large doses or in particularly sensitive patients, or when associated with other oxidant agents, can cause hemolytic crisis 6) . The association between aspirin intake and hemolytic episodes in patients with G6PDH has been reported on several occasions and in the majority of patients a severe hemolytic process had occurred after the ingestion of small therapeutic doses not exceeding 2 g/day [7][8][9][10] . Interestingly, in a small series of 40 cases of hemolytic crisis reported in a population of glucose-6-phosphate dehydrogenase deficiency patients, registered in Algeria, ingestion of aspirin, even at a low dosage ( ≤ 400 mg), preceded the crisis in 5% of cases 11) .…”

Section: Resultsmentioning

confidence: 99%

Glucose-6-Phosphate Dehydrogenase (G6PDH) Deficiency in a Patient with ST-Segment Elevation Acute Myocardial Infarction Successfully Treated by Simple Thrombectomy

Porto

Leo

Crea

2011

JAT

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We report the case of an 82-year-old Sardinian woman affected by "favism" (i.e. intolerance to fava beans) with chest pain associated with persistent massive ST elevation in V2-V6 leads, admitted to our department after transfer from a rural hospital without catheterization facilities. On immediate transfer to the catheterization laboratory for primary percutaneous intervention (PCI), coronary angiogram showed proximal left anterior descending (LAD) thrombotic occlusion. In consideration of her history of glucose-6 phosphate dehydrogenase deficiency and "loss of consciousness" at a young age after taking aspirin, which contraindicated aspirin therapy, we treated this patient using a new, two-step strategy, with an emergency minimalist intervention using manual thrombectomy and intracoronary glycoprotein b/ a (GP b a) inhibition with abciximab. Subsequent angiography control confirmed the persistence of Thrombolysis in Myocardial Infarction Trial (TIMI) grade 3 flow and the presence of an intermediate proximal LAD coronary lesion, which was not treated, also due to the persisting contraindication to aspirin. In our opinion, minimalist intervention with a thrombectomy device (especially in patients characterized by a high intracoronary thrombus burden) and/or with the use of a small balloon or gentle dilation, sustained by maximized antithrombotic therapy may represent an interesting and rational approach, allowing interventionalists to postpone stenting in the setting of primary PCI in special cases. J Atheroscler Thromb, 2011; 18:425-430.Key words; Favism, Myocardial infarction, Manual thrombectomy cessfully treated this patient using a two-step strategy, with an emergency minimalist intervention using manual thrombectomy and intracoronary glycoprotein b/ a (GP b a) inhibition with abciximab. This case shows that an aggressive, thrombectomyonly strategy may be sufficient to restore flow in an emergency, and recanalization may be sustained by a maximized antithrombotic regimen (abcximab, clopidogrel and heparin) allowing interventionalists to postpone stenting in the setting of primary PCI in special cases. Case PresentationA 82-year-old hypercholesterolemic Sardinian woman with chest pain of one-hour duration, associated with persistent massive ST elevation in V2-V6 leads, was admitted to our department after transfer

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“…Th ere are some drugs (such as Streptomycin, Aspirin, Ceft riaxone, etc.) that can cause severe anemia [7][8][9]. Ayurvedic medicine also recognized as Ayurveda is one of the world's oldest holistic (whole-body) healing systems.…”

Section: Introductionmentioning

confidence: 99%

Preclinical Anemia Panel Studies of “Makardhvaja” after Chronic Administration to Male Sprague-Dawley Rats

Ch¹,

Roy²,

Sikder³

et al. 2017

Biol Med (Aligarh)

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Aspirin-Induced Acute Haemolytic Anaemia in Glucose-6-Phosphate Dehydrogenase-Def icient Children with Systemic Arthritis

Cited by 27 publications

References 6 publications

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Glucose-6-Phosphate Dehydrogenase (G6PDH) Deficiency in a Patient with ST-Segment Elevation Acute Myocardial Infarction Successfully Treated by Simple Thrombectomy

Preclinical Anemia Panel Studies of “Makardhvaja” after Chronic Administration to Male Sprague-Dawley Rats

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