Three cases of hereditary nonspherocytic hemolytic anemia associated with red blood cell glutathione deficiency.
Three unrelated Japanese patients with chronic nonspherocytic hemolytic anemia wer found to have marked deficiency of red blood cell (RBC) reduced glutathoine (GSH) (4.4%, 13.1%, and 6.9% of normal, respectively). A panel of RBC enzyme assays showed that one patient had decreased glutathione synthetase activity and the other two were moderately deficient in gamma-glutamylcystine synthetase. Some family members of each patient showed mild deficiency of the respective enzymes. RBCs of these patients also showed a decreased level of glutathione-S-transferase as in previously described GSH-deficient cases. Hemolytic anemia was their only manifestation, and neither 5-oxoprolinemia nor 5-oxoprolinuria, which are usually associated with to generalized type of glutathione synthetase deficiency, was noted in our patients.
Hirono
A
A
Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
Iyori
H
H
Sekine
I
I
Ueyama
J
J
Chiba
H
H
Kanno
H
H
Fujii
H
H
Miwa
S
S
D000293:Adolescent; D000328:Adult; D000746:Anemia, Hemolytic, Congenital Nonspherocytic / Q000097:blood* / Q000201:enzymology / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D004796:Clinical Enzyme Tests; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005721:Glutamate-Cysteine Ligase / Q000172:deficiency* / Q000235:genetics; D005978:Glutathione / Q000097:blood / Q000187:drug effects*; D005979:Glutathione Peroxidase / Q000097:blood; D005980:Glutathione Reductase / Q000097:blood; D005981:Glutathione Synthase / Q000172:deficiency* / Q000235:genetics; D006801:Humans; D008297:Male; D010084:Oxidation-Reduction; D011761:Pyrrolidonecarboxylic Acid / Q000097:blood / Q000652:urine
D005979:Glutathione Peroxidase; D005980:Glutathione Reductase; D005721:Glutamate-Cysteine Ligase; D005981:Glutathione Synthase; D005978:Glutathione; D011761:Pyrrolidonecarboxylic Acid