ABSTRACT
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder. There are more than 400 million people worldwide with G6PD deficiency, and its distribution is similar to that of malaria. G6PD deficiency is an X-linked recessive disorder. Most patients with G6PD deficiency may be asymptomatic throughout their lives. They may present as neonatal jaundice, or acute and chronic hemolysis. The most important point in the management of G6PD deficiency is to avoid oxidative stress. The prevalence of G6PD deficiency in Korea is about 0.9%. However, a nationwide survey has revealed that the number of patients with enzymopathy is increasing. Immigration of different ethnicities into Korea, and the rise of interracial marriages will likely lead to an increase in the number of patients with G6PD deficiency.
Subject(s)
Humans , Infant, Newborn , Anemia, Hemolytic, Congenital , Anemia, Hemolytic, Congenital Nonspherocytic , Emigration and Immigration , Favism , Glucosephosphate Dehydrogenase , Glucosephosphate Dehydrogenase Deficiency , Hemolysis , Jaundice, Neonatal , Korea , Malaria , Marriage , Oxidative Stress , Prevalence , SplenectomyABSTRACT
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder. There are more than 400 million people worldwide with G6PD deficiency, and its distribution is similar to that of malaria. G6PD deficiency is an X-linked recessive disorder. Most patients with G6PD deficiency may be asymptomatic throughout their lives. They may present as neonatal jaundice, or acute and chronic hemolysis. The most important point in the management of G6PD deficiency is to avoid oxidative stress. The prevalence of G6PD deficiency in Korea is about 0.9%. However, a nationwide survey has revealed that the number of patients with enzymopathy is increasing. Immigration of different ethnicities into Korea, and the rise of interracial marriages will likely lead to an increase in the number of patients with G6PD deficiency.
Subject(s)
Humans , Infant, Newborn , Anemia, Hemolytic, Congenital , Anemia, Hemolytic, Congenital Nonspherocytic , Emigration and Immigration , Favism , Glucosephosphate Dehydrogenase , Glucosephosphate Dehydrogenase Deficiency , Hemolysis , Jaundice, Neonatal , Korea , Malaria , Marriage , Oxidative Stress , Prevalence , SplenectomyABSTRACT
BACKGROUND: The number of patients diagnosed with hereditary hemolytic anemia (HHA) has increased since the advent of novel diagnostic techniques that accurately identify this disorder. Here, we report data from a survey on the prevalence and characteristics of patients diagnosed with HHA in Korea from 2007 to 2011. METHODS: Information on patients diagnosed with HHA in Korea and their clinical and laboratory results were collected using a survey questionnaire. Globin gene and red blood cell (RBC) enzyme analyses were performed. In addition, we analyzed data collected by pediatricians. RESULTS: In total, 195 cases of HHA were identified. Etiologies identified for HHA were RBC membranopathies, hemoglobinopathies, and RBC enzymopathies, which accounted for 127 (64%), 39 (19.9%), and 26 (13.3%) cases, respectively. Of the 39 patients with hemoglobinopathies, 26 were confirmed by globin gene analysis, including 20 patients with beta-thalassemia minor, 5 patients with alpha-thalassemia minor, and 1 patient with unstable hemoglobin disease. CONCLUSION: The number of patients diagnosed with hemoglobinopathies and RBC enzymopathies has increased considerably since the previous survey on HHA in Korea, dated from 1997 to 2006. This is likely the result of improved diagnostic techniques. Nevertheless, there is still a need for more sensitive diagnostic tests utilizing flow cytometry and for better standardization of test results to improve the accuracy of diagnosis of RBC membranopathies in Korea. Additionally, more accurate assays for the identification of RBC enzymopathies are warranted.
Subject(s)
Humans , alpha-Thalassemia , Anemia, Hemolytic, Congenital , beta-Thalassemia , Diagnostic Tests, Routine , Erythrocytes , Flow Cytometry , Globins , Hematology , Hemoglobinopathies , Hemoglobins , Korea , Prevalence , Spherocytosis, Hereditary , Thalassemia , Surveys and QuestionnairesABSTRACT
Se evaluó la efectividad de la esplenectomía parcial (EP) en 17 pacientes con esferocitosis hereditaria atendidos en el Instituto de Hematología e Inmunología. La edad al diagnóstico fue de 6,71 ± 5,38 meses. Todos presentaron esplenomegalia. Un paciente presentó litiasis vesicular antes de la intervención. Los criterios para indicar la esplenectomía fueron: requerimientos transfusionales (82,4 por ciento), anemia crónica y esplenomegalia (11,7 por ciento) y esplenomegalia (5,9 por ciento). La edad al momento de la EP fue de 7,0 ± 2,6 años. La hemoglobina (Hb) estaba disminuida en el 94,1 por ciento de los enfermos; los reticulocitos aumentados en el 100 por ciento y la bilirrubina total e indirecta elevada en el 76,5 por ciento y 88,2 por ciento, respectivamente. El promedio de edad actual de los pacientes es de 16,24 ± 4,26 años, con un tiempo de evolución de 9,24 ± 4,47 años. Las variables de laboratorio posoperatorio mostraron incremento significativo de la Hb (p= 4 × 10-9) y disminución de los reticulocitos (p= 0,003). La tendencia en el tiempo de la Hb mantuvo estabilidad de los niveles alcanzados luego de la intervención, en todos los pacientes con más de 10 años de operados, no así para los reticulocitos. Dos pacientes presentaron crecimiento del fragmento esplénico; uno se asoció con mala respuesta clínico-hematológica. No se comprobó sepsis ni complicaciones tromboembólicas con posterioridad al proceder.
The effectiveness of partial splenomegalia (PS) was assessed in 17 patients with hereditary spherocytosis seen in the Hematology and Immunology Institute. Age at diagnosis was of 6.71 ± 5.38 months. All of them had splenomegalia. A patient had vesicular lithiasis before intervention. Criteria to presence of splenomegalia were: transfusion requirements (822.4 percent), chronic anemia and splenomegalia (11.7 percent) and splenomegalia (5.9 percent). Age at moment of PS was of( 7.0 ± 2.6 years). Hemoglobin (Hb) was low in the 94,1 percent of patients; reticulocytes increased in the 100 percent and the total and indirect bilirubin was high in the 76,5 percent and the 88,2 percent, respectively. Current mean age of patients is 16,24 ± 4,26 years with a course time of 9,24 ± 4,47 years. Postoperative laboratory variables showed a significant increase of Hb (p= 4 × 10-9) and a decrease of reticulocytes (p= 0.003). Trend in time of Hb remained stable in levels achieved after intervention in all patients with more than 10 years of operated on, but not for reticulocytes. Two patients showed a growing of splenic fragment; one was associated with a poor clinical-hematological response. There not sepsis or thromboembolism complications after procedure.
Subject(s)
Humans , Anemia, Hemolytic, Congenital , Spherocytosis, Hereditary/therapy , Splenectomy/methods , Treatment OutcomeABSTRACT
La glucosa-6-fosfato deshidrogenasa (G6PD) es la primera enzima de la vía pentosa fosfato y la principal fuente intracelular de nicotidamina adenina dinucleótido fosfato reducido (NADPH), compuesto comprometido en diversos procesos fisiológicos, por ejemplo defensa antioxidante (sobre todo células como los eritrocitos), modulación del crecimiento endotelial, eritropoyesis, vascularización y fagocitosis. La deficiencia de G6PD es la enzimopatía ligada al cromosoma X más común en el ser humano. Si bien se puede presentar en cualquier tipo de célula, su carencia absoluta es incompatible con la vida. Según la OMS, en el mundo hay más de 400 millones de personas afectadas por la deficiencia de la enzima, y para Colombia calculan una prevalencia de la deficiencia severa entre 3% y 7%, pero no se conocen los datos relativos a las alteraciones leves y moderadas, que también tienen efectos clínicos. El presente artículo revisa los aspectos biomoleculares más importantes de la enzima, su clasificación de acuerdo con la actividad y la movilidad electroforética, y también se mencionan algunos aspectos clínicos relacionados con la alteración de su actividad.
Glucose-6-phosphate dehydrogenase is the first enzyme in the pentose phosphate pathway and the main intracellular source of reduced nicotidamineadenine nucleotidephosphate (NADPH), involved in diverse physiological processes such as antioxidant defense, (for instance in the erythrocyte) endothelial growth modulation, erithropoyesis, vascularization and phagocitosis. G6PDH deficiency is the most common X-chromosome-linked enzymopathy in human beings. Although it is present in any type cell, its absolute deficiency is incompatible with life. According to WHO, 400 million people are affected by G6PD deficiency in the world but in Colombia, the severe form prevalence is about 3% to 7%. There are no data related to slight and moderate alterations, that also have clinical effects. This paper reviews some G6PD biomolecular aspects, its classification according to activity and electrophoretic mobility, as well as some main clinical aspects related to its activity alteration.