Top

Published in:

01-02-2013 | Case Report

G6PD deficiency-induced hemolysis in a Chinese diabetic patient: a case report with clinical and molecular analysis

Authors: Xue-Jiang Gu, Shuo-Ping Chen, Sheng-Jie Ge, Le-Qun Zheng, Da-Wang Wang, Fei-Xia Shen

Published in: Acta Diabetologica | Issue 1/2013

Abstract

A 59-year-old Chinese male patient was admitted at diagnosis of type1 diabetes with ketoacidosis. During the normalization of blood glucose with insulin, the patient developed acute hemolysis. The factors predisposing to hemolysis were not found, except the significantly diminished activity of glucose-6-phosphate dehydrogenase (G6PD). DNA analysis did not show any coding or intronic mutation in the G6PD gene. This is the first reported case of a Chinese patient in diabetic ketoacidosis with hemolysis induced by G6PD deficiency in the absence of mutations in the G6PD gene.

Kida K, Mimura G, Ito T, Murakami K, Ashkenazi I, Larson Z (2000) Incidence of type 1 diabetes mellitus in children aged 0–14 in Japan, 1986–1990, including an analysis for seasonality of onset and month of birth: JDS study. The data committee for childhood diabetes of Japan Diabetes Society (JDS). Diabetes Med 17:59–63CrossRef

Ruwende C, Hill A (1998) Glucose-6-phosphate dehydrogenase deficiency and malaria. J Mol Med 76:581–588PubMedCrossRef

Shalev O, Wollner A, Menczel J (1984) Diabetic ketoacidosis does not precipitate haemolysis in patients with the Mediterranean variant of glucose-6-phosphate dehydrogenase deficiency. Br Med J (Clin Res Ed) 288:179–180CrossRef

Rodriguez CA (1999) Erythrocytic glucose-6-phosphate dehydrogenase deficiency, hemolysis and diabetic ketoacidosis. An Med Interna 16:542–543

Galli-Tsinopoulou A, Nousia-Arvanitakis S (2000) Glucose-6-phosphate dehydrogenase deficiency-induced hemolysis in newly diagnosed diabetic monozygotic twins. J Pediatr Endocrinol Metab 13:669–672PubMed

Haroun M (2005) G 6 PD deficiency induced hemolysis in diabetic twins. Indian Pediatr 42:705–707PubMed

Goudar RK, Samuelson SJ, Motiei A, Chatterjee ST (2005) Can African variant G6PD deficiency trigger hemolysis in DKA? Am J Hemato l78:83–84CrossRef

Vanelli M, Chiari G, Capuano C, Iovane B, Bernardini A, Giacalone T (2003) The direct measurement of 3-beta-hydroxy butyrate enhances the management of diabetic ketoacidosis in children and reduces time and costs of treatment. Diabetes Nutr Metab 16:312–316PubMed

Vanelli M, Chiarelli F (2003) Treatment of diabetic ketoacidosis in children and adolescents. Acta Biomed 74:59–68PubMed

10.

Mason PJ, Bautista JM, Gilsanz F (2007) G6PD deficiency: the genotype-phenotype association. Blood Rev 21:267–283PubMedCrossRef

11.

Kletzien RF, Harris PK, Foellmi LA (1994) Glucose-6-phosphate dehydrogenase: a “housekeeping” enzyme subject to tissue-specific regulation by hormones, nutrients, and oxidant stress. FASEB J 8:174–181PubMed

12.

Errico MK, Iovane B, Bernardini A, Gliati D, Scarabello C, Fainardi V (2009) Haemolysis during diabetic ketoacidosis treatment in two girls with incomplete glucose-6-phosphate dehydrogenase deficiency. Acta Biomed 80:69–72PubMed

13.

Vanelli M, Lucentini L, Picco P, Galanello R, Chiari G, Adinolfi B et al (1996) Blood glucose normalization-induced haemolysis in three adolescents with type 1 diabetes mellitus at onset and unknown G-6-PD deficiency. J Pediatr Endocrinol Metab 9:193–196PubMed

14.

Le Pommelet C, Le Moullec N, Zunic P (2006) Diabetic ketoacidosis revealing glucose-6-phosphate dehydrogenase deficiency: description of an adult case. Diabetes Metab 32:636–637PubMedCrossRef

15.

Niazi GA (1991) Glucose-6-phosphate dehydrogenase deficiency and diabetes mellitus. Int J Hemato l54:295–298

16.

Saeed TK, Hamamy HA, Alwan AAS (1985) Association of glucose-6-phosphate dehydrogenase deficiency with diabetes mellitus. Diabet Med 2:110–112PubMedCrossRef

17.

Meloni T, Pacifico A, Forteleoni G, Meloni GF (1992) G6PD deficiency and diabetes mellitus in Northern Sardinian subjects. Haematologica 77:94–95PubMed

18.

Sobngwi E, Gautier JF, Kevorkian JP, Villette JM, Riveline JP, Zhang S et al (2005) High prevalence of glucose-6-phosphate dehydrogenase deficiency without gene mutation suggests a novel genetic mechanism predisposing to ketosis-prone diabetes. J Clin Endocrinol Metab 90:4446–4451PubMedCrossRef

19.

Zhang Z, Liew CW, Handy DE, Zhang Y, Leopold JA, Hu J et al (2010) High glucose inhibits glucose-6-phosphate dehydrogenase, leading to increased oxidative stress and beta-cell apoptosis. FASEB J 24:1497–1505PubMedCrossRef

20.

Salvemini F, Franzé A, Iervolino A, Filosa S, Salzano S, Ursini MV (1999) Enhanced glutathione levels and oxidoresistance mediated by increased glucose-6-phosphate dehydrogenase expression. J Biol Chem 274:2750–2757PubMedCrossRef

21.

Cappellini MD, Fiorelli G (2008) Glucose-6-phosphate dehydrogenase deficiency. Lancet 371:64–74PubMedCrossRef

22.

Shalev O, Eliakim R, Lugassy GZ, Menczel J (1985) Hypoglycemia-induced hemolysis in glucose-6-phosphate dehydrogenase deficiency. Acta haemato l74:227–229CrossRef

23.

Meir A, Kleinman Y, Rund D, Da’as N (2003) Metformin-induced hemolytic anemia in a patient with glucose-6- phosphate dehydrogenase deficiency. Diabetes Care 26:956–957PubMedCrossRef

24.

Vinzio S, Andrès E, Perrin AE, Schlienger JL, Goichot B (2004) Glibenclamide-induced acute haemolytic anaemia revealing a G6PD deficiency. Diabetes Res Clin Pract 64:181–183PubMedCrossRef

Title: G6PD deficiency-induced hemolysis in a Chinese diabetic patient: a case report with clinical and molecular analysis
Authors: Xue-Jiang Gu
Shuo-Ping Chen
Sheng-Jie Ge
Le-Qun Zheng
Da-Wang Wang
Fei-Xia Shen
Publication date: 01-02-2013
Publisher: Springer Milan
Published in: Acta Diabetologica / Issue 1/2013
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-010-0236-y

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

G6PD deficiency-induced hemolysis in a Chinese diabetic patient: a case report with clinical and molecular analysis

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2013

Serum levels of bone resorption markers are decreased in patients with type 2 diabetes

Adipocytokines mark insulin sensitivity in euthyroid Hashimoto’s patients

Transglutaminase 2 transamidation activity during first-phase insulin secretion: natural substrates in INS-1E

TNF-α induces early growth response gene-1 expression via ERK1/2 activation in endothelial cells

Contribution of insulin deficiency and insulin resistance to the development of type 2 diabetes: nature of early stage diabetes

GGT levels in type II diabetic patients with acute coronary syndrome (does diabetes have any effect on GGT levels in acute coronary syndrome?)

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page