title: Severe hemolysis and renal failure in glucose-6-phosphate dehydrogenase deficient patients with hepatitis E.
abstract: Hemolytic anemia as a complication of acute hepatitis is not uncommon in patients with glucose-6-phosphate dehydrogenase deficiency. However, severe hemolysis in these patients is rare. We report a cohort of five patients with acute viral hepatitis E who developed severe intravascular hemolysis and unusually high levels of bilirubin. All five patients had severe, complicated, protracted courses of illness. Four patients developed acute renal failure, and two of these required hemodialysis. To the best of our knowledge this is the first report of a cohort of patients with glucose-6-phosphate dehydrogenase deficiency and acute viral hepatitis E with severe intravascular hemolysis. We emphasize the fact that intravascular hemolysis should be suspected in patients with acute viral hepatitis E with marked bilirubinemia and anemia. Measures to prevent renal failure should be taken in such cases.
authors.affiliation: Department of Medicine, The Aga Khan Medical College, Karachi, Pakistan.
authors.forename: Shahab
authors.initials: S
authors.lastname: Abid
authors.forename: A Haleem
authors.initials: AH
authors.lastname: Khan
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism*; D006461:Hemolysis; D016751:Hepatitis E / Q000097:blood* / Q000150:complications*; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology*; D008297:Male; D008661:Metabolism, Inborn Errors / Q000150:complications*; D012720:Severity of Illness Index
chemical_list: D005954:Glucosephosphate Dehydrogenase