G6PD deficiency in childhood borderline tuberculoid leprosy: A rare case

Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is known to cause haemolysis in patients with leprosy receiving multidrug therapy (MDT) containing dapsone. Dapsone releases N-hydroxy metabolites that can cause hemolytic anemia and hyperbilirubinemia. Concomitant G6PD significantly increases the risk of severe intravascular hemolysis. Severe hemolysis can cause mortality in children. It is crucial to be aware before the diagnosis of leprosy because it determines the treatment. Rifampicin, ofloxacin and minocycline (ROM) regimen are indicated as alternative treatment. Childhood leprosy with G6PD deficiency is a rare disease, and it is infrequently tested. A G6PD test should be standard procedure for all institutions before starting MDT, because it can be helpful in reducing the occurrence of haemolytic complications. We report a case of a 14-year-old Indonesian boy with borderline tuberculoid leprosy who was on monthly ROM regimen with good improvement.