title: Relationship among glucose-6-phosphate dehydrogenase (G-6-PD) activity, G-6-PD variants and reticulocytosis in neonates of northeast Thailand.
abstract: BACKGROUND
  Misdiagnosis of G-6-PD deficiency in neonates, at risk of severe hemolytic episodes, extreme hyperbilirubinemia, and bilirubin encephalopathy, could possibly occur due to presence of reticulocytes, which contain higher amounts of G-6-PD than mature erythrocytes. G-6-PD mutations in the population might also affect G-6-PD activity. This study evaluated the relationship among G-6-PD activity, G-6-PD variants and reticulocytosis in northeastern Thai neonates.
  
  
  METHODS
  Blood samples obtained from routine fluorescence spot test examination for G-6-PD deficiency were analyzed using a quantitative enzymatic assay and for common G-6-PD mutations by restriction fragment length polymorphism (RFLP)-PCR. Correlation between G-6-PD activity and percent reticulocytosis was determined.
  
  
  RESULTS
  Among 106G-6-PD-deficient (G-6PD activity<7.0U/g Hb) neonates, no significant association is observed between G-6PD activity and percent reticulocytosis (r=0.125, p-value=0.201), but there is a weak correlation in G-6-PD-normal neonates (r=0.377, p-value=0.014). There is a high frequency of G-6-PD Viangchan in male hemizygous and female heterozygous G-6-PD-deficient and G-6-PD-normal neonates.
  
  
  CONCLUSIONS
  A high reticulocytosis does not bias measurements of enzyme activity in G-6-PD-deficient neonates. Also, G-6-PD activity varies among female heterozygous neonates, and G-6-PD mutation analysis provides a reliable method to detect G-6-PD deficiency.
authors: Department of Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand. Electronic address: sutpra@kku.ac.th.
authors: Suttiphan
authors: S
authors: Kitcharoen
authors: Graduate School, Khon Kaen University, Khon Kaen, Thailand.
authors: Sumalai
authors: S
authors: Dechyotin
authors: Graduate School, Khon Kaen University, Khon Kaen, Thailand.
authors: Noppmats
authors: N
authors: Khemtonglang
authors: Diagnostic Microscopy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors: Chanudda
authors: C
authors: Kleesuk
mesh_terms: D016477:Artifacts; D057075:Enzyme Assays; D005260:Female; D060005:Genotyping Techniques; D005954:Glucosephosphate Dehydrogenase / Q000097:blood / Q000235:genetics* / Q000378:metabolism*; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000097:blood / Q000201:enzymology / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009154:Mutation; D045262:Reticulocytosis / Q000235:genetics*; D013785:Thailand
chemical_list: D005954:Glucosephosphate Dehydrogenase
keywords: Erythrocyte; G-6-PD activity; G-6-PD variant; Neonate; Reticulocytosis