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葡萄糖-6-磷酸脱氢酶缺乏症 COVID-19 患者接受羟氯喹后发生严重溶血的病例报告。

A case report of serious haemolysis in a glucose-6-phosphate dehydrogenase-deficient COVID-19 patient receiving hydroxychloroquine.

机构信息

Infectious Diseases Clinic, University Hospital Brugmann, Brussels, Belgium.

Internal Medicine Department, University Hospital Brugmann, Brussels, Belgium.

出版信息

Infect Dis (Lond). 2020 Sep;52(9):659-661. doi: 10.1080/23744235.2020.1774644. Epub 2020 Jun 4.

Abstract

While the COVID-19 epidemic occurred since December 2019, as of end April 2020, no treatment has been validated or invalidated by accurate clinical trials. Use of hydroxychloroquine has been popularised on mass media and put forward as a valid treatment option without strong evidence of efficacy. Hydroxychloroquine (HCQ) has its own side effects, some of which are very serious like acute haemolysis in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. Side effects may be worse than the disease itself. Belgian national treatment guidelines recommend the use of HCQ in mild to severe COVID-19 disease. As opinions, politics, media and beliefs are governing COVID-19 therapy, performance of randomised controlled blinded clinical trials became difficult. Results of sound clinical trials are eagerly awaited. We report a case of acute haemolysis leading to admission in intensive care unit and renal failure in a patient with uncovered G6PD deficiency.

摘要

自 2019 年 12 月爆发 COVID-19 疫情以来,截至 2020 年 4 月底,尚无经准确临床试验验证或否定的治疗方法。羟氯喹在大众媒体上广受欢迎,并被提出作为一种有效的治疗选择,但缺乏强有力的疗效证据。羟氯喹(HCQ)有其自身的副作用,其中一些非常严重,如葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症患者的急性溶血性贫血。副作用可能比疾病本身更严重。比利时国家治疗指南建议在轻度至重度 COVID-19 疾病中使用 HCQ。由于意见、政治、媒体和信仰正在主导 COVID-19 的治疗,进行随机对照双盲临床试验变得困难。人们急切地等待着可靠的临床试验结果。我们报告了一例 G6PD 缺乏症未被发现的患者发生急性溶血性贫血导致入住重症监护病房和肾衰竭的病例。

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