oxidative haemolysis

Precipitants of oxidative haemolysis

Drugs - Dapsone, Co-trimoxazole, Rasburicase, Sulfasalazine, Antimalarials, Chloramphenicol

                (Aspirin, Quinine and Pencillin but not at conventional doses)

Food - Fava beans

Infection

Other acute illness - e.g. DKA

Blood film Morphology

oxidative haemolysis.jpg

 

G6PD Deficiency

Intro

X-linked

Female carriers have increased resistance to malaria

Variable phenotype

  • Mild in Black Africans

  • Moderate in Asians

  • Severe in Mediterraneans

 

Pathophysiology

G6PD reduces nicotinamide adenine dinucleotide phosphate (NADP) to NADPH

This is the only source of NADPH for the red cell

NADPH is needed to produce reduce glutathione

Reduced glutathione clears free oxidants --> deficiency results in increased susceptibility to oxidative stress.

Normal Pathways

G6PD.jpg

—> Red cell damage as a result of G6PD deficiency

G6PD def.jpg