Poor correlation between hemolysis and jaundice in glucose 6-phosphate dehydrogenase-deficient babies.
BACKGROUND
The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ.


METHODS
Four groups of babies were included in the study: (i) G6PD deficient with NNJ; (ii) G6PD deficient without NNJ; (iii) G6PD normal with NNJ; and (iv) normal controls. Babies with other known causes of jaundice were excluded from the study. All subjects underwent the following investigations on day 3-5 after birth: hemoglobin level (Hb), serum bilirubin level, carboxyhemoglobin (CO-Hb) concentration, reticulocyte count and full blood picture. The results of the investigations were compared between the groups using SPSS version 11.


RESULTS
Babies with G6PD and jaundice had a similar percentage of CO-Hb to babies with G6PD without NNJ or babies with normal G6PD and NNJ (1.76 +/- 0.40% vs 1.66 +/- 0.31% and 1.67 +/- 0.28%, respectively; P: 0.23 and 0.41, respectively). Total Hb levels and reticulocyte counts were not significantly different between the groups. The blood film showed more (even though not reaching significance) hemolysis in the G6PD patients but results of the blood film were very similar for G6PD patients with and those without NNJ.


CONCLUSIONS
Hemolysis is not a main determinant of neonatal jaundice in G6PD-deficient babies.
Jalloh
Salamatu
S
Department of Pediatrics, Universiti Sains Malaysia, Kelantan, Malaysia.
Van Rostenberghe
Hans
H
Yusoff
Narazah M
NM
Ghazali
Selamah
S
Nik Ismail
Nik Zainal
NZ
Matsuo
Masafumi
M
Wahab
Nor Akmal
NA
Nishio
Hisahide
H
D001663:Bilirubin / Q000097:blood; D002263:Carboxyhemoglobin / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000097:blood / Q000503:physiopathology*; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000503:physiopathology*; D008296:Malaysia; D008297:Male; D017701:Reticulocyte Count; D012307:Risk Factors
D006454:Hemoglobins; D002263:Carboxyhemoglobin; D001663:Bilirubin