Division of Pediatric Critical Care, Department of Pediatrics, Harbor-UCLA Medical Center, 1000 W Carson St, Building N-25, Box 491, Torrance, CA, 90502, USA.
Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA.
J Med Case Rep. 2022 Mar 14;16(1):106. doi: 10.1186/s13256-022-03322-w.
Glucose-6-phosphate dehydrogenase deficiency is a rarely recognized predisposing factor for rhabdomyolysis. Rhabdomyolysis with coronavirus disease 2019 has been increasingly seen during the pandemic. We report the uncommon occurrence of coronavirus disease 2019 pneumonia, severe rhabdomyolysis, and acute renal failure in the setting of glucose-6-phosphate dehydrogenase deficiency.
A 19-year-old African American male presented with myalgias, diaphoresis, and dark urine. Testing for severe acute respiratory syndrome coronavirus 2 was positive. He had severe rhabdomyolysis with creatine kinase levels up to 346,695 U/L. He was oliguric and eventually required hemodialysis. Progressive hypoxemia, methemoglobinemia, and hemolytic anemia occurred following one dose of rasburicase for hyperuricemia. Glucose-6-phosphate dehydrogenase deficiency was diagnosed. Full recovery followed a single volume exchange transfusion and simple packed red blood cell transfusions.
Glucose-6-phosphate dehydrogenase deficiency may predispose individuals to rhabdomyolysis due to severe acute respiratory syndrome coronavirus 2, presumably due to altered host responses to viral oxidative stress. Early screening for glucose-6-phosphate dehydrogenase deficiency can be useful for management of patients with rhabdomyolysis.
葡萄糖-6-磷酸脱氢酶缺乏症是导致横纹肌溶解症的罕见易患因素。在大流行期间，越来越多的人出现了与 2019 年冠状病毒病相关的横纹肌溶解症。我们报告了葡萄糖-6-磷酸脱氢酶缺乏症患者罕见的 2019 年冠状病毒病肺炎、严重横纹肌溶解症和急性肾衰竭病例。
一名 19 岁的非裔美国男性出现肌肉疼痛、出汗和深色尿液。严重急性呼吸综合征冠状病毒 2 检测呈阳性。他患有严重的横纹肌溶解症，肌酸激酶水平高达 346695 U/L。他出现少尿，最终需要进行血液透析。在因高尿酸血症使用拉布立酶治疗后，出现进行性低氧血症、高铁血红蛋白血症和溶血性贫血。诊断为葡萄糖-6-磷酸脱氢酶缺乏症。单次容量交换输血和单纯浓缩红细胞输血后完全康复。
葡萄糖-6-磷酸脱氢酶缺乏症可能使个体易患因严重急性呼吸综合征冠状病毒 2 引起的横纹肌溶解症，可能是由于宿主对病毒氧化应激的反应改变。早期筛查葡萄糖-6-磷酸脱氢酶缺乏症有助于管理横纹肌溶解症患者。
