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Glucose-6-phosphate dehydrogenase deficiency

Last reviewed: 30 Sep 2024
Last updated: 21 Jun 2023

Summary

Definition

History and exam

Key diagnostic factors

  • at-risk demographic
  • positive family history
  • history of infection or exposure to oxidative drugs or broad (fava) beans
  • jaundice
  • pallor
  • dark urine
Full details

Other diagnostic factors

  • nausea
  • cataract
  • splenomegaly
Full details

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)
Full details

Diagnostic tests

1st tests to order

  • CBC
  • reticulocyte count
  • urinalysis
  • unconjugated (indirect) bilirubin
  • LDH
  • haptoglobin
  • peripheral blood smear
Full details

Tests to consider

  • G6PD fluorescent spot test
  • G6PD spectrophotometry
  • molecular analysis
Full details

Emerging tests

  • point of care testing

Treatment algorithm

ACUTE

acute hemolysis

neonates with prolonged indirect hyperbilirubinemia

ONGOING

chronic nonspherocytic hemolytic anemia

Contributors

Authors

Atul Bhanu Mehta, MA, MD, FRCP, FRCPath

Professor of Haematology and Consultant Haematologist

Royal Free Hospital and University College London School of Medicine

London

UK

Disclosures

ABM declares that he has no competing interests.

Peer reviewers

Lucio Luzzatto, MD

Professor of Hematology

University of Firenze

Florence

Italy

Disclosures

LL declares that he has no competing interests.

  • Differentials

    • Sickle cell disease
    • Autoimmune hemolytic anemia
    • Isoimmune hemolytic anemia: for example, ABO incompatibility
    More Differentials
  • Guidelines

    • Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation
    • Laboratory diagnosis of G6PD deficiency. A British Society for Haematology Guideline
    More Guidelines
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