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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Clinical spectrum and severity of hemolytic anemia in glucose 6-phosphate dehydrogenase-deficient children receiving dapsone
Blood, Volume 120, No. 20, Year 2012
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Description
Drug-induced acute hemolytic anemia led to the discovery of G6PD deficiency. However, most clinical data are from isolated case reports. In 2 clinical trials of antimalarial preparations containing dapsone (4,4′-diaminodiphenylsulfone; 2.5 mg/kg once daily for 3 days), 95 G6PD-deficient hemizygous boys, 24 G6PD-deficient homozygous girls, and 200 girls heterozygous for G6PD deficiency received this agent. In the first 2 groups, there was a maximum decrease in hemoglobin averaging -2.64 g/dL (range -6.70 to +0.30 g/dL), which was significantly greater than for the comparator group receiving artemether-lumefantrine (adjusted difference -1.46 g/dL; 95% confidence interval -1.76, -1.15). Hemoglobin concentrations were decreased by ≥ 40% versus pretreatment in 24/119 (20.2%) of the G6PD-deficient children; 13/119 (10.9%) required blood transfusion. In the heterozygous girls, the mean maximum decrease in hemoglobin was -1.83 g/dL (range +0.90 to -5.20 g/dL); 1 in 200 (0.5%) required blood transfusion. All children eventually recovered. All the G6PD-deficient children had the G6PD A- variant, ie, mutations V68MandN126D. Drug-induced acutehemolytic anemia in G6PD A- subjects can be life-threatening, depending on the nature and dosage of the drug trigger. Therefore, contrary to current perception, in clinical terms the A- type of G6PD deficiency cannot be regarded as mild. This study is registered at http://www.clinicaltrials.gov as NCT00344006 and NCT00371735. © 2012 by The American Society of Hematology.
Authors & Co-Authors
Pamba, Allan
United Kingdom, Brentford
Glaxosmithkline Plc.
Richardson, Naomi D.
United Kingdom, Abingdon
Magenta Communications Ltd.
Carter, Nick
United Kingdom, Brentford
Glaxosmithkline Plc.
Duparc, Stephan
Switzerland, Geneva
Medicines for Malaria Venture
Premji, Zulfiqarali G.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Tiono, Alfred Bewendtaoré
Burkina Faso, Ouagadougou
Centre National de Recherche et de Formation Sur le Paludisme
Luzzatto, Lucio
Italy, Florence
Università Degli Studi Di Firenze
Statistics
Citations: 106
Authors: 7
Affiliations: 6
Identifiers
Doi:
10.1182/blood-2012-03-416032
ISSN:
00064971
Research Areas
Genetics And Genomics
Maternal And Child Health
Participants Gender
Male
Female