Messina M F, Lombardo F, Crisafulli G, Salzano G, Rosano M, Di Giorgio R M
Dipartimento di Scienze Pediatriche Mediche e Chirurgiche, Fisiologiche e della Nutrizione, University of Messina, Italy.
J Pediatr Endocrinol Metab. 2004 Dec;17(12):1671-3. doi: 10.1515/jpem.2004.17.12.1671.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy and hemolytic anemia can be triggered by many drugs, by the ingestion of fava beans, and by metabolic imbalances. Nonetheless, only sporadic reports of hemolytic anemia due to G6PD deficiency in patients with type 1 diabetes mellitus (DM1) have been reported to date. We describe an 8 year-old Sicilian boy who suffered from hemolytic anemia some days after admission for DM1. On admission, acid-base equilibrium was normal but 4 days later he presented hemolytic anemia with G6PD deficiency, confirmed by personal and family history and laboratory evaluation. We suggest that the hemolytic crisis in this patient was triggered by the relative hypoglycemia that followed insulin administration. The interference of acidosis, infections, drugs, food or other triggering agents was excluded. This report demonstrates that hemolysis may represent a possible complication of DM treatment in patients with G6PD deficiency and we recommend careful clinical surveillance in these patients.
葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症是最常见的酶病，许多药物、食用蚕豆以及代谢失衡都可能引发溶血性贫血。尽管如此，迄今为止，仅零星报道过1型糖尿病（DM1）患者因G6PD缺乏症导致溶血性贫血的病例。我们描述了一名8岁的西西里男孩，他在因DM1入院几天后患上了溶血性贫血。入院时，酸碱平衡正常，但4天后他出现了伴有G6PD缺乏症的溶血性贫血，这通过个人和家族病史以及实验室检查得以证实。我们认为该患者的溶血危机是由胰岛素注射后出现的相对性低血糖引发的。排除了酸中毒、感染、药物、食物或其他触发因素的干扰。本报告表明，溶血可能是G6PD缺乏症患者DM治疗的一种潜在并发症，我们建议对这些患者进行仔细的临床监测。
