Skip to main content

Advertisement

Log in

G6PD deficiency-induced hemolysis in a Chinese diabetic patient: a case report with clinical and molecular analysis

  • Case Report
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

A 59-year-old Chinese male patient was admitted at diagnosis of type1 diabetes with ketoacidosis. During the normalization of blood glucose with insulin, the patient developed acute hemolysis. The factors predisposing to hemolysis were not found, except the significantly diminished activity of glucose-6-phosphate dehydrogenase (G6PD). DNA analysis did not show any coding or intronic mutation in the G6PD gene. This is the first reported case of a Chinese patient in diabetic ketoacidosis with hemolysis induced by G6PD deficiency in the absence of mutations in the G6PD gene.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Kida K, Mimura G, Ito T, Murakami K, Ashkenazi I, Larson Z (2000) Incidence of type 1 diabetes mellitus in children aged 0–14 in Japan, 1986–1990, including an analysis for seasonality of onset and month of birth: JDS study. The data committee for childhood diabetes of Japan Diabetes Society (JDS). Diabetes Med 17:59–63

    Article  CAS  Google Scholar 

  2. Ruwende C, Hill A (1998) Glucose-6-phosphate dehydrogenase deficiency and malaria. J Mol Med 76:581–588

    Article  PubMed  CAS  Google Scholar 

  3. Shalev O, Wollner A, Menczel J (1984) Diabetic ketoacidosis does not precipitate haemolysis in patients with the Mediterranean variant of glucose-6-phosphate dehydrogenase deficiency. Br Med J (Clin Res Ed) 288:179–180

    Article  CAS  Google Scholar 

  4. Rodriguez CA (1999) Erythrocytic glucose-6-phosphate dehydrogenase deficiency, hemolysis and diabetic ketoacidosis. An Med Interna 16:542–543

    Google Scholar 

  5. Galli-Tsinopoulou A, Nousia-Arvanitakis S (2000) Glucose-6-phosphate dehydrogenase deficiency-induced hemolysis in newly diagnosed diabetic monozygotic twins. J Pediatr Endocrinol Metab 13:669–672

    PubMed  CAS  Google Scholar 

  6. Haroun M (2005) G 6 PD deficiency induced hemolysis in diabetic twins. Indian Pediatr 42:705–707

    PubMed  Google Scholar 

  7. Goudar RK, Samuelson SJ, Motiei A, Chatterjee ST (2005) Can African variant G6PD deficiency trigger hemolysis in DKA? Am J Hemato l78:83–84

    Article  Google Scholar 

  8. Vanelli M, Chiari G, Capuano C, Iovane B, Bernardini A, Giacalone T (2003) The direct measurement of 3-beta-hydroxy butyrate enhances the management of diabetic ketoacidosis in children and reduces time and costs of treatment. Diabetes Nutr Metab 16:312–316

    PubMed  CAS  Google Scholar 

  9. Vanelli M, Chiarelli F (2003) Treatment of diabetic ketoacidosis in children and adolescents. Acta Biomed 74:59–68

    PubMed  CAS  Google Scholar 

  10. Mason PJ, Bautista JM, Gilsanz F (2007) G6PD deficiency: the genotype-phenotype association. Blood Rev 21:267–283

    Article  PubMed  CAS  Google Scholar 

  11. Kletzien RF, Harris PK, Foellmi LA (1994) Glucose-6-phosphate dehydrogenase: a “housekeeping” enzyme subject to tissue-specific regulation by hormones, nutrients, and oxidant stress. FASEB J 8:174–181

    PubMed  CAS  Google Scholar 

  12. Errico MK, Iovane B, Bernardini A, Gliati D, Scarabello C, Fainardi V (2009) Haemolysis during diabetic ketoacidosis treatment in two girls with incomplete glucose-6-phosphate dehydrogenase deficiency. Acta Biomed 80:69–72

    PubMed  CAS  Google Scholar 

  13. Vanelli M, Lucentini L, Picco P, Galanello R, Chiari G, Adinolfi B et al (1996) Blood glucose normalization-induced haemolysis in three adolescents with type 1 diabetes mellitus at onset and unknown G-6-PD deficiency. J Pediatr Endocrinol Metab 9:193–196

    PubMed  CAS  Google Scholar 

  14. Le Pommelet C, Le Moullec N, Zunic P (2006) Diabetic ketoacidosis revealing glucose-6-phosphate dehydrogenase deficiency: description of an adult case. Diabetes Metab 32:636–637

    Article  PubMed  CAS  Google Scholar 

  15. Niazi GA (1991) Glucose-6-phosphate dehydrogenase deficiency and diabetes mellitus. Int J Hemato l54:295–298

    Google Scholar 

  16. Saeed TK, Hamamy HA, Alwan AAS (1985) Association of glucose-6-phosphate dehydrogenase deficiency with diabetes mellitus. Diabet Med 2:110–112

    Article  PubMed  CAS  Google Scholar 

  17. Meloni T, Pacifico A, Forteleoni G, Meloni GF (1992) G6PD deficiency and diabetes mellitus in Northern Sardinian subjects. Haematologica 77:94–95

    PubMed  CAS  Google Scholar 

  18. Sobngwi E, Gautier JF, Kevorkian JP, Villette JM, Riveline JP, Zhang S et al (2005) High prevalence of glucose-6-phosphate dehydrogenase deficiency without gene mutation suggests a novel genetic mechanism predisposing to ketosis-prone diabetes. J Clin Endocrinol Metab 90:4446–4451

    Article  PubMed  CAS  Google Scholar 

  19. Zhang Z, Liew CW, Handy DE, Zhang Y, Leopold JA, Hu J et al (2010) High glucose inhibits glucose-6-phosphate dehydrogenase, leading to increased oxidative stress and beta-cell apoptosis. FASEB J 24:1497–1505

    Article  PubMed  CAS  Google Scholar 

  20. Salvemini F, Franzé A, Iervolino A, Filosa S, Salzano S, Ursini MV (1999) Enhanced glutathione levels and oxidoresistance mediated by increased glucose-6-phosphate dehydrogenase expression. J Biol Chem 274:2750–2757

    Article  PubMed  CAS  Google Scholar 

  21. Cappellini MD, Fiorelli G (2008) Glucose-6-phosphate dehydrogenase deficiency. Lancet 371:64–74

    Article  PubMed  CAS  Google Scholar 

  22. Shalev O, Eliakim R, Lugassy GZ, Menczel J (1985) Hypoglycemia-induced hemolysis in glucose-6-phosphate dehydrogenase deficiency. Acta haemato l74:227–229

    Article  Google Scholar 

  23. Meir A, Kleinman Y, Rund D, Da’as N (2003) Metformin-induced hemolytic anemia in a patient with glucose-6- phosphate dehydrogenase deficiency. Diabetes Care 26:956–957

    Article  PubMed  Google Scholar 

  24. Vinzio S, Andrès E, Perrin AE, Schlienger JL, Goichot B (2004) Glibenclamide-induced acute haemolytic anaemia revealing a G6PD deficiency. Diabetes Res Clin Pract 64:181–183

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fei-Xia Shen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gu, XJ., Chen, SP., Ge, SJ. et al. G6PD deficiency-induced hemolysis in a Chinese diabetic patient: a case report with clinical and molecular analysis. Acta Diabetol 50, 89–92 (2013). https://doi.org/10.1007/s00592-010-0236-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-010-0236-y

Keywords

Navigation