Acute Hemolytic Anemia Complicating Viral Hepatitis in Patients with Glucose-6-Phosphate Dehydrogenase Deficiency
Authors: GERALD SALEN
Journal: Annals of Internal Medicine (1966)

Article1 December 1966Acute Hemolytic Anemia Complicating Viral Hepatitis in Patients with Glucose-6-Phosphate Dehydrogenase DeficiencyGERALD SALEN, M.D., FRANZ GOLDSTEIN, M.D., F.A.C.P., FARID HAURANI, M.D., F.A.C.P., C. WILMER WIRTS, M.D., F.A.C.P.GERALD SALEN, M.D., FRANZ GOLDSTEIN, M.D., F.A.C.P., FARID HAURANI, M.D., F.A.C.P., C. WILMER WIRTS, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-6-1210 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough shortened erythrocyte survival can frequently be demonstrated, severe anemia has rarely been noted during acute viral hepatitis (1-3). In the few reported cases of hemolytic anemia complicating hepatitis no mechanism explaining the increased red cell destruction has been established (4-6). Increased splenic pulp pressure (7) or elevated gamma globulin levels (8), observed in viral hepatitis, could not be related to the development of hemolysis (2, 4, 6). Burka, Weaver, and Marks (9) most recently suggested that erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may predispose to the development of hemolytic anemia during viral hepatitis.This report deals with three patients who...References1. CAWEINHAGEDORNOWEN MJABCA: Anemia of hepatic disease studied with radiochromium. Gastroenterology 38: 324, 1960. CrossrefMedlineGoogle Scholar2. PITCHERWILLIAMS CSR: Reduced red cell survival in jaundice and its relation to abnormal glutathione metabolism. Clin. Sci. 24: 239, 1963. MedlineGoogle Scholar3. CONRADSCHWARTZYOUNG MEFDAA: Infectious hepatitis; a generalized disease. A study of renal, gastrointestinal and hematologic abnormalities. Amer. J. Med. 37: 789, 1964. CrossrefMedlineGoogle Scholar4. KIVEL RM: Hematologic aspects of acute viral hepatitis. Amer. J. 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A simplified procedure for detecting a specific hypersusceptibility to drug hemolysis. JAMA 180: 386, 1962. CrossrefMedlineGoogle Scholar11. BEUTLERROBSONBUTTERWEISER EME: The mechanism of glutathione destruction and protection in drug-sensitive and non-sensitive erythrocytes. In vitro studies. J. Clin. Invest. 36: 617, 1957. CrossrefMedlineGoogle Scholar12. ZINKHAM WH: An in-vitro abnormality of glutathione metabolism in erythrocytes from normal newborns: mechanism and clinical significance. Pediatrics 23: 18, 1959. MedlineGoogle Scholar13. ZINKHAMLENHARD WHRE: Metabolic abnormalities of erythrocytes from patients with congenital nonspherocytic hemolytic anemia. J. Pediat. 55: 319, 1959. CrossrefMedlineGoogle Scholar14. BEUTLERDERNFLANAGANALVING ERJCLAS: The hemolytic effect of primaquine. VII. Biochemical studies of drug sensitive erythrocytes. J. Lab. Clin. Med. 45: 286, 1955. MedlineGoogle Scholar15. CARSONFLANAGANICKESALVING PCLCEAS: Enzymatic deficiency in primaquine sensitive erythrocytes. Science 124: 484, 1956. CrossrefMedlineGoogle Scholar16. JANDL JH: The Heinz body hemolytic anemias. Ann. Intern. Med. 58: 702, 1963. LinkGoogle Scholar17. JANDLENGLEALLEN JHLKDW: Oxidative hemolysis and precipitation of hemoglobin. I. Heinz body anemias as an acceleration of red cell aging. J. Clin. Invest. 39: 1818, 1960. CrossrefMedlineGoogle Scholar18. ALLENJANDL DWJH: Oxidative hemolysis and precipitation of hemoglobin. II. Role of thiols in oxidant drug action. J. Clin. Invest. 40: 454, 1961. CrossrefMedlineGoogle Scholar19. JACOBJANDL HSJH: Effects of sulfhydryl inhibition on red blood cells. I. Mechanism of hemolysis. J. Clin. Invest. 41: 779, 1962. CrossrefMedlineGoogle Scholar20. JACOBJANDL HSJH: Effects of sulfhydryl inhibition on red blood cells. II. Studies in vivo. Ibid., p. 1514. Google Scholar21. JONDERKO G: Glutathione level in the blood in the course of parenchymatous injury of the liver. Arch. Polon. Med. Interne. 31: 316, 1961. Google Scholar22. MARKSJOHNSONHERSCHBERG PAABE: Effects of age on enzyme activity in erythrocytes. Proc. Nat. Acad. Sci. USA 44: 529, 1958. CrossrefMedlineGoogle Scholar23. CHOREMISKATTAMISKYRIAZAKOUGAVRIILIDOU CCAME: Viral hepatitis in G-6-PD deficiency. Lancet 1: 269, 1966. CrossrefMedlineGoogle Scholar24. WONG HB: Viral hepatitis in G-6-PD deficiency. Ibid., p. 882. Google Scholar25. TREYBURNSSAUNDERS CDGSJ: Treatment of hepatic coma by exchange blood transfusions. New Eng. J. Med. 274: 473, 1966. CrossrefMedlineGoogle Scholar26. BERGERLIVERSAGECHALMERSGRAHAMMCGOLDRICKSTOHLMAN RLRJTCJHDMF: Exchange transfusion in the treatment of fulminating hepatitis. Ibid., p. 497. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, PennsylvaniaFrom the Division of Gastroenterology and the Cardeza Foundation, Department of Medicine, Jefferson Medical College Hospital, Philadelphia, Pa.This study was supported in part by grants AM 08141-01 and CA 05554-04, U. S. Public Health Service, Washington, D. C.At the time of this study Gerald Salen, M.D., was a Postdoctoral Research Fellow in Gastroenterology, supported by fellowship F2 AM-28, 395-01 from the National Institutes of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md.This paper was presented in part at the Meeting of the American Gastroenterological Association, May 28, 1966, Chicago, Ill.Requests for reprints should be addressed to Franz Goldstein, M.D., F.A.C.P., 1025 Walnut St., Philadelphia, Pa. 19107. 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BURKA, M.D., F.A.C.P.Glucose-6 Phosphate Dehydrogenase Deficiency, Infectious Hepatitis, Acute Hemolysis, and Renal FailureS. M. PHILLIPS, M.D., N. P. SILVERS, M.D.Genetically Determined Polymorphisms of Erythrocyte Enzymes in ManThe narcotic addict as a medical patientAcute Renal Failure Complicating Rickettsial Infections in Glucose-6-Phosphate Dehydrogenase-Deficient IndividualsANDREW WHELTON, JAMES V. DONADIO JR., BENNETT L. ELISBERG, M.D.Virus-Induced Hemolysis in Erythrocytes Deficient in Glucose-6-phosphate DehydrogenaseINTRAVASCULAR HÆMOLYSIS AND COAGULATIONSICKLE-CELL ANÆMIA IN G.-6-P.D. DEFICIENCY 1 December 1966Volume 65, Issue 6Page: 1210-1220KeywordsDehydrogenasesGlucose-6-phosphate dehydrogenase deficiencyHemolytic anemiaHepatitisHepatitis CHepatitis DHepatitis EHospital medicineMedical servicesMetabolic disorders Issue Published: 1 December 1966 PDF downloadLoading ...