Biochemical parameters will show increased serum bilirubin and lactate dehydrogenase levels but reduced serum haptoglobin level. Glucose-6-phosphate dehydrogenase (G6PD) deficiency affects the red blood cell metabolism pathway particularly the hexose monophosphate shunt. This means there is a high risk of hemolytic anemia when exposed to triggers, often requiring medical intervention and treatment (3, 5). The electronic patient problem list is one part of an EMR where the patient data is coded in the back-end database of the record.
What are G6PD deficiency symptoms?
Glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDD) is a genetic (hereditary) disorder. However, you can prevent the more serious G6PDD symptoms by avoiding certain foods. Those who do completely recover from their symptoms once treatment is received for the underlying trigger of the condition. However, it’s important to learn how you can manage the condition and prevent symptoms from developing. Problems may occur if you are exposed to certain medicines or foods that may harm your blood cells.
How is G6PD deficiency diagnosed, and what tests are typically used?
Healthcare providers typically start by taking a complete medical history. They might ask if you’ve recently changed medications or had an infection. They might ask if anyone else in your family shows signs of G6PD deficiency. Talk to your healthcare provider if you have G6PD deficiency and need to take antibiotics or malaria medications, as they can tell you what's safe. This is not a complete list of items you should avoid if you have G6PD deficiency. There are other medications that only cause red cell breakdown if taken in high doses.
Differential Diagnosis
Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme found in every cell of the body. It is part of the chemical mechanism by which the body is able to process glucose. Although every cell contains G6PD, it plays a special role in the red blood cell (RBC). In the RBC, the only source of NADPH is the pentose phosphate pathway, the first step of which is controlled by G6PD. At the same time, since the main function of the RBC is to transport oxygen from the lungs to the rest of the body, it is uniquely susceptible to oxidative stress. It is not surprising, therefore, that the most common clinical manifestation of an inherited deficiency in G6PD is the accelerated breakdown of the RBCs leading to something called Acute Hemolytic Anemia.
These rigid and fragmented cells may also lead to intravascular hemolysis. Hemoglobin denatures and precipitates intracellular to become Heinz bodies. G6PD is the most common human enzyme defect, affecting over 400 million people worldwide.
Foods and substances to avoid
Standard terminologies used for the patient problem list include ICD-9, ICD-10, and SNOMED CT. ICD-9 and ICD-10 are disease classification schema maintained in the U.S. by the Centers for Medicare and Medicaid Services. Either may be used to populate the electronic patient problem list. alcohol use disorder treatment SNOMED CT is a true medical terminology specifically intended for use in EMRs and maintained by the International Health Terminology Standards Development Organisation, which is owned and governed by 27 countries. Healthcare providers use different treatments based on your situation.
The acute hemolytic anemia is caused by rapidly developing intravascular hemolysis with hemoglobinuria (blood in the urine). The anemia may be self-limiting as new young red cells are made with near normal enzyme levels. G6PD is a genetic disorder that what happens when you mix cannabis and alcohol happens when your body doesn’t have enough glucose-6-phosphate dehydrogenase (G6PD) enzyme. G6PD helps red blood cells work and protects them from harmful substances. G6PD can cause life-threatening hemolytic anemia that requires blood transfusions.
Variants are classified I through V by the amount of activity of the G6PD enzyme. Because the gene is X-linked, males are more likely to present with clinically significant hemolysis. Females who are homozygous, or who are heterozygous with skewed X inactivation that results in a high proportion of affected X chromosomes may also be affected. G6PD deficiency is when the body is missing or doesn’t have enough of an enzyme called G6PD (glucose-6-phosphate dehydrogenase).
Certain medications can also trigger episodes of hemolytic anemia in those with G6PD deficiency. Some of these medications are commonly used in the United States (1, 12). Glutathione is an important https://sober-home.org/hypertension-how-just-1-alcohol-drink-a-day-may/ antioxidant, a compound that guards your cells against damage from free radicals and oxidative stress. Research has highlighted glutathione’s role in fighting inflammation in some cancer cells (8).
Although screening tests for G6PD deficiencies are available, they are not routinely performed in the United States. However, screening should be considered in newborns with severe jaundice resistant to phototherapy or who have a family history or ethnicity suggestive of G6PD deficiency. The most common screening method includes a rapid fluorescent spot test to detect the generation of NADPH from NADP.
The utility of the coded patient problem list is that it can be leveraged by computerized drug–disease interaction-checking applications. In the case of G6PD, the patient problem list could be populated with a disease terminology code for G6PD deficiency that serves as a trigger for drug–disease interaction checking. Although health information systems help clinicians improve care with CPOE and pharmacist order verification, rare inherited disease states often become missed opportunities for drug-safety interventions.
- Jaundice results from elevations in unconjugated bilirubin, usually only after more than 50% of erythrocytes have been hemolyzed.
- This early destruction of red blood cells is known as hemolysis, and it can eventually lead to hemolytic anemia.
- Thus, testing may need to be repeated several weeks after the acute event.
- Many hospitals are increasingly utilizing patient-specific data in the electronic medical record (EMR) coupled with clinical decision support (CDS) tools to facilitate safer and more effective patient care.
- When this process is actively occurring, it is called a hemolytic episode.
The new classification does not by itself affect current WHO recommendations with respect to the use of primaquine and tafenoquine, which are based on the level of G6PD activity in each individual. Thus, after half a century, a revision of the WHO classification was needed. An added stimulus came from the approval in 2018 of tafenoquine for the treatment of malaria by the United States of America Food and Drug Administration and by the Therapeutic Goods Administration of the Australian government. Like primaquine, tafenoquine can produce acute haemolytic anaemia in G6PD-deficient patients, but unlike primaquine, once started it cannot be discontinued. Safe administration of tafenoquine and primaquine therefore requires testing for G6PD deficiency, whether at the point of care or otherwise. Hemolytic anemia could be life-threatening, depending on how severely you suffer from it.