Metabolism of the hexose monophosphate shunt in glucose-6-phosphate dehydrogenase deficiency and closely interrelated reactions.

The metabolic changes of red blood cells from 25 patients with chronic hemolytic anemia caused by G6PD deficiency were investigated. The average G6PD activity exhibited 5 per cent of the normal control. The glucose oxidation was in most cases reduced even by 50 per cent. Three groups could be distinguished according to their degree of methylene blue stimulation of the oxidative pentose phosphate pathway. These results are in agreement with changes of the kinetic constants for NADP, NADPH and G6P, respectively. The filtrability of red blood cells decreased in all cases of G6PD deficiency but no correlation was found with the survival time. First results of a preventive medication with D-L-alpha-tocopherol let assume a reduction of chronic hemolysis.