Kimmick G, Owen J
Hematology/Oncology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1082, USA.
South Med J. 1996 Nov;89(11):1097-8. doi: 10.1097/00007611-199611000-00015.
We report a case of severe oxidative hemolysis and rhabdomyolysis in a patient with sickle cell trait and glucose-6-phosphate dehydrogenase (G6PD) deficiency. The patient was a 34-year-old black man admitted 24 hours after vigorous exercise with myalgias, malaise, myoglobinuria, anemia, low haptoglobin, and a peripheral blood smear with bite cells consistent with oxidative hemolysis. He had two similar episodes within 21 months of the initial admission. Subsequent evaluation resulted in the diagnosis of sickle cell trait and G6PD deficiency; muscle enzyme levels were normal. G6PD deficiency and sickle cell trait can be expected to occur simultaneously in up to 1% of black males. A second red blood cell defect should be considered when severe hemolysis is seen in a person with sickle cell trait.
我们报告了一例患有镰状细胞性状和葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症的患者发生严重氧化性溶血和横纹肌溶解的病例。该患者为一名34岁黑人男性，在剧烈运动24小时后入院，伴有肌痛、不适、肌红蛋白尿、贫血、触珠蛋白降低，外周血涂片显示有咬痕细胞，符合氧化性溶血表现。在初次入院后的21个月内，他又出现了两次类似发作。后续评估确诊为镰状细胞性状和G6PD缺乏症；肌肉酶水平正常。预计高达1%的黑人男性会同时出现G6PD缺乏症和镰状细胞性状。当镰状细胞性状患者出现严重溶血时，应考虑存在第二种红细胞缺陷。
