Pregnancy Favism and Severe Hemolytic Anemia in a Patient with Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency: A Case Report
Authors:   Gynecology and Obstetrics Resident. Hospital General de Cancún “Dr. Jesús Kumate Rodriguez”, Secretaría de Salud. Facultad de Medicina de la Universidad Autónoma de Yucatán., Martínez Tamara Espinosa , Hernández María Eugenia Núñez ,   Gynecologist and Obstetrician. Hospital General de Cancún “Dr. Jesús Kumate Rodriguez”, Secretaría de Salud., Echeverría Alexis Emir Noguera ,   Médico Cirujano, Médico Residente de Cirugía General, Guerrero María Fernanda Ibarra ,   Pediatrics Resident. Clínica Hospital Mérida, ISSSTE. Facultad de Medicina de la Universidad Autónoma de Yucatán., Acosta Viridiana Noemí Victoria ,   Gynecology and Obstetrics Resident. Hospital General de Cancún “Dr. Jesús Kumate Rodriguez”, Secretaría de Salud. Facultad de Medicina de la Universidad Autónoma de Yucatán., Enzana Lourdes Araceli López ,   Gynecology and Obstetrics Resident. Hospital General de Cancún “Dr. Jesús Kumate Rodriguez”, Secretaría de Salud. Facultad de Medicina de la Universidad Autónoma de Yucatán., Bautista Deisy Areli Lárraga ,   Gynecology and Obstetrics Resident. Hospital General de Cancún “Dr. Jesús Kumate Rodriguez”, Secretaría de Salud. Facultad de Medicina de la Universidad Autónoma de Yucatán., Hernández Héctor Alejandro Soto ,   Hospital General B ISSSTE, Ciudad Juárez, Chihuahua. Universidad Autónoma de Guanajuato., Marfil Natalia Aleli Gómez ,   Social Service MD Intern. Universidad para el Bienestar Benito Juárez García.
Published: February 2025

Introduction: Favism is a genetic disease-causing hemolytic anemia in Mexico, primarily due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Factors triggering favism include infections, pregnancy, certain drugs, and eating beans. The disease is inherited recessively and is more common in men. Diagnosing and managing favism during pregnancy is crucial, as it can lead to severe hemolytic anemia and neonatal jaundice.

Case presentation: A female patient, aged 18, presented with severe anemia and thrombocytopenia during her 20-week pregnancy. During pregnancy, the patient experienced jaundice and anemia at 21.5 weeks of gestation. Despite not presenting evidence of bleeding, transfusions were performed due to critical hemoglobin levels. G6PD deficiency was confirmed at 9 days of hospital admission, indicating severe hemolytic anemia.

Clinical discussion: The hemolytic crisis in a pregnant woman with favism was triggered by pregnancy and repeated infections of candidiasis. Clinical symptoms of hemolysis were confirmed through G6PD and Coombs tests, and blood transfusion was recommended to prevent complications. The patient's hemoglobin was monitored for signs of active intravascular hemolysis, and a folic acid tablet was recommended during the crisis. Post-crisis management involved periodic controls of hemoglobin, hematocrit, lactate dehydrogenase, and bilirubin.

Conclusion: Favism, a prevalent condition in Mexico, should be considered in patients with a family history of hemolytic anemia or compatible symptoms. Early diagnosis and proper management are crucial to prevent complications in the mother and fetus. A multidisciplinary approach, genetic counseling, and medical education are essential for effective management.