An unexpected emergency request for glucose-6-phosphate dehydrogenase testing in a 9-year-old African American boy.
METHODS
9-year-old African American male.
Recently diagnosed with acute lymphoblastic leukemia (ALL) after investigation into a large anterior mediastinal mass causing airway compression.
The day before the unexpected urgent glucose-6-phosphate dehydrogenase (G6PD) request, the patient was diagnosed with an aggressive form of leukemia and a significant tumor mass causing airway compression. A computed tomography (CT) scan indicated potential renal involvement. Based on this information and the size of the mass, the patient was referred for immediate chemotherapy. However, there was a concern that he could develop tumor lysis syndrome (TLS) during treatment. To avoid this condition, the pediatric intensive care unit (ICU) sought to pretreat the child with rasburicase, which led to the emergency G6PD request.
Unknown.
Largely unknown, but no apparent chronic diseases.


RESULTS
Three weeks of progressively worsening lymphadenopathy, coughing, night sweats, mild hepatosplenomegaly, and breathing difficulty when supine. The patient arrived at the medical center for airway management and had a temperature of 36.1°C; blood pressure, 120/87 mmHg; pulse, 115 bpm; respiratory rate, 22 breaths per minute, with labored breathing but normal O(2) saturation while upright and awake, in room air.


RESULTS
Table 1.
Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX.
Peter
P
Platteborze
Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX.
Renee
R
Matos
Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX.
Vinod
V
Gidvany-Diaz
Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, TX.
Kelly
K
Wilhelms
D002648:Child; D004638:Emergency Treatment / Q000379:methods*; D005954:Glucosephosphate Dehydrogenase / Q000378:metabolism*; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D005954:Glucosephosphate Dehydrogenase
deficiency; glucose-6-phosphate dehydrogenase; leukemia; rasburicase; tumor lysis syndrome; uric acid