Articles

Correlation between Hemolysis and Jaundice in Glucose 6-Phosphate Dehydrogenase Deficient Neonates

Abstract

Glucose 6-phosphate dehydrogenase (G6PD) deficiency is an enzyme deficiency of the red blood cells and the most important disease of hexose monophosphate pathway. The role of hemolysis in the pathophysiology of neonatal jaundice due to G6PD deficiency is in contencious. Our aim is to study the role of hemolysis in neonatal jaundice associated with G6PD deficiency. This prospective descriptive study has been done on 244 neonates who were admitted with the symptoms and signs of icter to the Ali-Asghar Children Hospital, affiliated to Iran University of Medical Sciences, Tehran, Iran, during April 2006 to April 2007. Two groups of the babies, G6PD-defcient with neonatal jaundice and G6PD-normal with neonatal jaundice, were compared based on the parameters related to hemolysis such as hemoglobin, reticulocyte count and bilirubin level. The criteria of hemolysis in our study were reticulocyte count more than >5% and hemoglobin less than 0.05). The present study indicate, G6PD- deficiency as a major cause of neonatal jaundice and hemolysis is not a main determinant of neonatal jaundice in G6PD-deficient babies and most of them have non hemolytic jaundice.

Maisels MJ. Jaundice. In: MacDonald MG, Mullett MD, Seshia MMK, editors. Avery's Neonatology: Pathophysiology and Management of the Newborn. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006. p. 802-4.

Stoll BJ, Kliegman RM. Jaundice and hyperbilirubinemia in the newborn. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders; 2004. p. 562-96.

Halamek LP, Stevenson DK. Neonatal jaundice and liver disease. In: Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 7th ed. St. Louis: CV Mosby; 2006; p. 1309-50.

Kaplan M, Hammerman C. Glucose-6-phosphate dehydrogenase deficiency: a potential source of severe neonatal hyperbilirubinaemia and kernicterus. Semin Neonatol 2002;7(2):121-8.

Iranpour R, Akbar MR, Haghshenas I. Glucose-6-phosphate dehydrogenase deficiency in neonates. Indian J Pediatr 2003;70(11):855-7.

Ahmed H, Yukubu AM, Hendrickse RG. Neonatal jaundice in Zaria, Nigeria: a second prospective study. West Afr J Med 1995;14(1):15-23.

Madan N, Sundaram KR, Bhargava SK, Sood SK. Glucose-

-phosphate dehydrogenase deficiency & neonatal hyperbilirubinaemia. Indian J Med Res 1989;90:306-13.

Eghbalian F, Monsef AR. Evalution of glucose-6-phosphate dehydrogenase deficiency without hemolysis in icteric newborns. Iran J Pediatr 2007;17(1): 36-40.

Yaish HM, Niazi GA, al Shaalan M, Khan S, Ahmed GS. Increased incidence of hyperbilirubinaemia in 'unchallenged' glucose-6-phosphate dehydrogenase deficiency in term Saudi newborns. Ann Trop Paediatr 1991;11(3):259-66.

Jalloh S, Van Rostenberghe H, Yusoff NM, Ghazali S, Nik Ismail NZ, Matsuo M, et al. Poor correlation between hemolysis and jaundice in glucose 6-phosphate dehydrogenase- deficient babies. Pediatr Int 2005;47(3):258-61.

Rodgers PA, Vreman HJ, Dennery PA, Stevenson DK. Sources of carbon monoxide (CO) in biological systems and applications of CO detection technologies. Semin Perinatol1994;18(1):2-10.

Seidman DS, Shiloh M, Stevenson DK, Vreman HJ, Gale R. Role of hemolysis in neonatal jaundice associated with glucose-6 phosphate dehydrogenase deficiency. J Pediatr 1995;127(5):804-6. 13. Valaes T. Severe neonatal jaundice associated with glucose-

-phosphate dehydrogenase deficiency: pathogenesis and global epidemiology. Acta Paediatr Suppl 1994;394:58-76.

Kaplan M, Renbaum P, Levy-Lahad E, Hammerman C, Lahad A, Beutler E. Gilbert syndrome and glucose-6- phosphate dehydrogenase deficiency: a dose-dependent genetic interaction crucial to neonatal hyperbilirubinemia. Proc Natl Acad Sci U S A 1997;94(22):12128-32.

Javier MC, Krauss A, Nesin M. Corrected end-tidal carbon monoxide closely correlates with the corrected reticulocyte count in coombs' test-positive term neonates. Pediatrics 2003;112(6 Pt 1):1333-7.

Files
IssueVol 47, No 5 (2009) QRcode
SectionArticles
Keywords
G6PD-deficiency hemolysis neonatal jaundice
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Marzban A, Mosavinasab N. Correlation between Hemolysis and Jaundice in Glucose 6-Phosphate Dehydrogenase Deficient Neonates. Acta Med Iran. 1;47(5):379-382.