G6PD-deficiency: a potential high-risk group to copper and chlorite ingestion.

Although humans may accept fairly large amounts of orally ingested copper (0.25 to 1.0 gm) without visible harmful effects, patients with Wilson's disease, and persons with G6PD deficiency may represent persons at unusual risk to hemolytic anemia from ingestion of Cu(II). This study reports that in vitro exposure of G6PD deficient red blood cells to copper produced marked elevations of methemoglobin and decreases in GSH when compared with normal red cells. Chlorite, a by-product of chlorine dioxide disinfection of water, produced decreases in GSH and G6PD activity, while increasing methemoglobin levels markedly over red cells with normal G6PD activity. The combined action of chlorite and copper was additive in producing increased levels of hemoglobin and decreases in levels of GSH and G6PD deficient cells. The combined ingestion of copper and chlorite may represent an increased risk to persons with G6PD deficiency.