Salvati A M, Maffi D, Caprari P, Pasquino M T, Caforio M P, Tarzia A
Laboratorio di Biochimica Clinica, Istituto Superiore di Sanità, Roma.
Ann Ist Super Sanita. 1999;35(2):193-203.
G6PD deficiency is the most common enzymopathy in the world. The highest frequency values are found in tropical Africa, in the Middle East, in some areas of the Mediterranean, in tropical and sub-tropical Asia and in Oceania. This genetic defect shows sex linked inheritance and a marked heterogeneity. At least 400 abnormal variants with different biochemical characteristics and about 100 diverse mutations have been identified. In most cases the phenotypic expression is a marked decrease in erythrocyte G6PD activity. The most common clinical consequences are neonatal jaundice and sporadic haemolytic crises caused by a number of drugs, by infections or by ingestion of fava beans. A few cases of chronic non-spherocytic haemolytic anaemia associated with rare molecular variants have been reported. Early diagnosis, education and epidemiologic surveillance have been proved to be cornerstones in the prevention of the haemolytic disease. Therefore they should be taken into account in the national health programmes, especially in the countries with high prevalence rates.
葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症是世界上最常见的酶病。在热带非洲、中东、地中海部分地区、热带和亚热带亚洲以及大洋洲发现了最高频率值。这种遗传缺陷表现为性连锁遗传和明显的异质性。已鉴定出至少400种具有不同生化特征的异常变体和约100种不同的突变。在大多数情况下,表型表达是红细胞G6PD活性显著降低。最常见的临床后果是新生儿黄疸以及由多种药物、感染或食用蚕豆引起的散发性溶血危机。已报告了少数与罕见分子变体相关的慢性非球形细胞溶血性贫血病例。早期诊断、教育和流行病学监测已被证明是预防溶血性疾病的基石。因此,应将它们纳入国家卫生计划,特别是在患病率高的国家。