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一名葡萄糖-6-磷酸脱氢酶(G6PD)正常患者出现意外的伯氨喹诱导的溶血:来自尼泊尔的病例报告

Unexpected Primaquine-Induced Hemolysis in a G6PD-Normal Patient: A Case Report From Nepal.

作者信息

Khadka Aarju, Subedi Sachet, Lama Nisha, Bhattarai Indu, Deuba Chandrashekhar, Khatri Uttam, Regmi Nisha

机构信息

College of Medical Sciences Teaching Hospital Bharatpur Nepal.

Tribhuvan University Institute of Medicine, Maharajgunj Medical Campus Chitwan Nepal.

出版信息

Clin Case Rep. 2025 Mar 7;13(3):e70303. doi: 10.1002/ccr3.70303. eCollection 2025 Mar.

DOI:10.1002/ccr3.70303
PMID:40062310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11888929/
Abstract

Primaquine, an antimalarial drug, is essential for preventing relapses of . However, it poses a risk of hemolytic anemia, particularly in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. This case report details a 27-year-old male with normal G6PD levels who developed hemolytic anemia following primaquine therapy for malaria. Despite a normal quantitative G6PD analysis, the patient experienced a significant drop in hemoglobin, necessitating early discontinuation of the drug. This case highlights the potential for hemolysis in G6PD-normal patients, underscoring the importance of close monitoring and the limitations of current G6PD screening methods.

摘要

伯氨喹是一种抗疟药物,对于预防[疾病名称]的复发至关重要。然而,它存在导致溶血性贫血的风险,尤其是在葡萄糖-6-磷酸脱氢酶(G6PD)缺乏的患者中。本病例报告详细描述了一名27岁男性,其G6PD水平正常,在接受伯氨喹治疗疟疾后发生了溶血性贫血。尽管定量G6PD分析结果正常,但患者的血红蛋白显著下降,因此必须提前停药。该病例突出了G6PD正常的患者发生溶血的可能性,强调了密切监测的重要性以及当前G6PD筛查方法的局限性。

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本文引用的文献

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Case Series of Primaquine-Induced Haemolytic Events in Controlled Trials with G6PD Screening.葡萄糖-6-磷酸脱氢酶(G6PD)筛查的对照试验中伯氨喹诱导溶血事件的病例系列
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The haematological consequences of Plasmodium vivax malaria after chloroquine treatment with and without primaquine: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis.氯喹治疗后有无伯氨喹治疗对间日疟原虫疟疾的血液学后果:全球抗疟药物耐药网络系统评价和个体患者数据荟萃分析。
BMC Med. 2019 Aug 1;17(1):151. doi: 10.1186/s12916-019-1386-6.
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Clinical Spectrum of Primaquine-induced Hemolysis in Glucose-6-Phosphate Dehydrogenase Deficiency: A 9-Year Hospitalization-based Study From the Brazilian Amazon.葡萄糖-6-磷酸脱氢酶缺乏症患者中伯氨喹诱导溶血的临床谱:一项基于巴西亚马逊地区9年住院病例的研究
Clin Infect Dis. 2019 Sep 27;69(8):1440-1442. doi: 10.1093/cid/ciz122.
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Evaluation of a Novel Quantitative Test for Glucose-6-Phosphate Dehydrogenase Deficiency: Bringing Quantitative Testing for Glucose-6-Phosphate Dehydrogenase Deficiency Closer to the Patient.新型葡萄糖-6-磷酸脱氢酶缺乏症定量检测的评估:使葡萄糖-6-磷酸脱氢酶缺乏症的定量检测更贴近患者。
Am J Trop Med Hyg. 2019 Jan;100(1):213-221. doi: 10.4269/ajtmh.18-0612.
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Barriers to routine G6PD testing prior to treatment with primaquine.在使用伯氨喹啉治疗前进行常规葡萄糖-6-磷酸脱氢酶(G6PD)检测的障碍。
Malar J. 2017 Aug 10;16(1):329. doi: 10.1186/s12936-017-1981-y.
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Validation of the rapid test Carestart(tm) G6PD among malaria vivax-infected subjects in the Brazilian Amazon.在巴西亚马逊地区间日疟原虫感染患者中对Carestart™ G6PD快速检测进行验证。
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Assessment of Point-of-Care Diagnostics for G6PD Deficiency in Malaria Endemic Rural Eastern Indonesia.印度尼西亚东部疟疾流行农村地区葡萄糖-6-磷酸脱氢酶缺乏症即时诊断评估
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