Glucose-6-phosphate dehydrogenase deficiency

Last reviewed: 2 Jan 2023
Last updated: 07 Apr 2022



History and exam

Key diagnostic factors

  • presence of risk factors
  • jaundice
  • pallor
  • dark urine
More key diagnostic factors

Other diagnostic factors

  • nausea
  • cataract
  • splenomegaly
Other diagnostic factors

Risk factors

  • male sex
  • neonate
  • ethnic origin in the Mediterranean, sub-Saharan Africa, Middle East, or Southeast Asia
  • family history
  • recent exposure to oxidative drugs
  • infection
  • recent exposure to broad beans (favism)
More risk factors

Diagnostic investigations

1st investigations to order

  • FBC
  • reticulocyte count
  • urinalysis
  • unconjugated (indirect) bilirubin
  • lactate dehydrogenase (LDH)
  • haptoglobin
  • peripheral blood smear
More 1st investigations to order

Investigations to consider

  • G6PD fluorescent spot test
  • G6PD spectrophotometry
  • molecular analysis
More investigations to consider

Emerging tests

  • point of care testing

Treatment algorithm


acute haemolysis

neonates with prolonged indirect hyperbilirubinaemia


chronic non-spherocytic haemolytic anaemia



Atul Bhanu Mehta, MA, MD, FRCP, FRCPath

Professor of Haematology and Consultant Haematologist

Royal Free Hospital and University College London School of Medicine




ABM declares that he has no competing interests.

Peer reviewers

Lucio Luzzatto, MD

Professor of Hematology

University of Firenze




LL declares that he has no competing interests.

  • Differentials

    • Sickle cell disease
    • Autoimmune haemolytic anaemia
    • Isoimmune haemolytic anaemia: for example, ABO incompatibility
    More Differentials
  • Guidelines

    • Laboratory diagnosis of G6PD deficiency. A British Society for Haematology Guideline
    • Guidelines for malaria prevention in travellers from the UK
    More Guidelines
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