Drug-induced Hemolysis in G6PD Deficiency: an Unusual Presentation of a Common Clinical Condition

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency can present a diagnostic dilemma owing to the varying degrees of disease severity and the wide range of precipitating factors. Here, we report a case of a 56-year-old man who presented with signs and symptoms of heart failure and, during the course of treatment, developed intravascular hemolysis. On investigation, he was found to be G6PD deficient. Following discontinuation of the fixed-dose combination of isosorbide dinitrate and hydralazine, the clinical condition of the patient improved, and there were no further episodes of hemolysis. The case highlights the need for a high degree of suspicion of G6PD deficiency in patients with unexplained signs and symptoms of intravascular hemolysis.

Metabolic Cardiomyopathies and Cardiac Defects in Inherited Disorders of Carbohydrate Metabolism: A Systematic Review

“…Patients are mostly asymptomatic however when exposed to triggers (drugs, infectious diseases and fava bean consumption), they may develop life threatening acute hemolytic anemia. Our literature search produced several reports of single or few G6PH-deficient patients describing with cardiac symptoms, which included: CD, HF, TVR, severe MVS, PVSD, PDA, coronary artery disease and ST-segment elevation [58,[60][61][62][63][64][65][66] (Table 3). More recently, studies on large patient cohorts have also been performed to investigate whether patients with G6PDH-deficiency present a higher predisposition to cardiovascular diseases and the results are still controversial.…”