Glucose-6-phosphate dehydrogenase deficiency
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Synopsis

G6PD deficiency has variable phenotypes attributed to the severity of the enzyme deficiency. G6PD is classified into 5 variations correlating to the amount of enzyme activity. Affected neonates may present with hyperbilirubinemia and hemolytic anemia, but many patients are asymptomatic. Some patients will have a chronic anemia from ongoing hemolysis, while others will be asymptomatic until a trigger, often environmental (ie, food or medication) or infectious, incites a hemolytic episode.
Signs and symptoms include pallor, dark urine, dyspnea, tachycardia, jaundice, and fatigue. Severe anemic hemolysis may occur in patients who have been exposed to bacterial or viral infections, the antimalarial drug primaquine, some antibiotics, or fava beans.
Management focuses on minimizing exposure to potential triggers that can incite hemolytic events and supportive management during anemic episodes.
Codes
ICD10CM:D55.0 – Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency
SNOMEDCT:
124134002 – Deficiency of glucose-6-phosphate dehydrogenase
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Sickle cell disease
- Alpha / beta thalassemia
- Hereditary spherocytosis
- Pyruvate kinase deficiency
- Hemolytic disease of the fetus and newborn
- Cholestasis of sepsis
- Hemolytic disease secondary to infection – often tick-borne illnesses, pneumonia, or hepatitis
- Biliary atresia
- ABO incompatibility / transfusion reaction
- Disseminated intravascular coagulation
- Systemic lupus erythematosus
- Thrombotic thrombocytopenic purpura
- Myelodysplastic syndromes
- Acute blood loss anemia
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:02/03/2019
Last Updated:01/16/2022
Last Updated:01/16/2022