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1.
Article in Chinese | WPRIM | ID: wpr-928701

ABSTRACT

OBJECTIVE@#To explore the genotype mutation characteristics of patients with glucose-6-phosphate dehydrogenase(G6PD) deficiency in Wuhan.@*METHODS@#A total of 1 321 neonates with positive screening and outpatients were received G6PD mutation detection, 12 kinds of common G6PD mutation in Chinese people was detected by using multicolor melting curve analysis (MMCA) method, for those with negative results, the enzyme activity and clinical information were analyzed, sequencing was recommended after informed consent when it is necessary.@*RESULTS@#Among 1321 patients, a total of 768 mutations were detected out, with a detection rate of 58.1%. A total of 18 types of G6PD genotypes were identified, including c.1388G>A, c.1376G>T, c.95G>A, c.1024C>T, c.871G>A, c.392G>T, c.487G>A, c.1360C>T, c.1004C>A, c.517T>C, c.592C>T, c.94C>G, c.152C>T, c.320A>G, c.1028A>G, c.1316G>A, c.1327G>C and c.1376G>C, including 683 male hemizygotes, 3 female homozygotes, 80 female heterozygotes and 2 female compound heterozygous.@*CONCLUSION@#A total of 18 types of G6PD mutations are identified in the reaserch, and c.94C>G, c.1028A>G and c.1327G>C are first reported in Chinese population. The most common G6PD mutation types in Wuhan are c.1388G>A, c.1376G>T, c.95G>A.


Subject(s)
Asians/genetics , Female , Genotype , Glucosephosphate Dehydrogenase/genetics , Glucosephosphate Dehydrogenase Deficiency/genetics , Heterozygote , Humans , Infant, Newborn , Male , Mutation
2.
Autops. Case Rep ; 11: e2021285, 2021. graf
Article in English | LILACS | ID: biblio-1249016

ABSTRACT

Acquired Hemophagocytic Lymphohistiocytosis is a rare and deadly syndrome resulting from an overactive immune system, with uncontrolled activation of macrophages and lymphocytes, hypercytokinemia, and systemic inflammatory response. A 75-year-old male presented with typical anginal pain and was diagnosed with the acute coronary syndrome, which required a percutaneous transluminal coronary angioplasty. Instead of resolving the symptoms, the patient began to exhibit pyrexia and worsening altered sensorium with progressing renal failure, anemia, thrombocytopenia and respiratory failure. This constellation of symptoms caused the patient to require mechanical ventilation and hemodialysis. Upon laboratory analysis, hyperferritinemia provided an indication to the diagnosis of acquired hemophagocytic lymphohistiocytosis. After the initiation of dexamethasone, the patient made a significant recovery and was discharged from the hospital.


Subject(s)
Humans , Male , Aged , Lymphohistiocytosis, Hemophagocytic/complications , Hyperferritinemia/diagnosis , Dexamethasone/therapeutic use , Acute Coronary Syndrome/complications , Glucosephosphate Dehydrogenase Deficiency
3.
Article in Chinese | WPRIM | ID: wpr-879881

ABSTRACT

OBJECTIVE@#To analyze the screening results of glucose-6-phosphate dehydrogenase (G6PD) deficiency and gene mutation distribution of G6PD deficiency in preterm infants in Chengdu, China, in order to provide a basis for the improvement of G6PD screening process in preterm infants.@*METHODS@#Fluorescent spot test for G6PD deficiency using dried blood spots was used for G6PD screening of 54 025 preterm infants born from January 1, 2015 to December 31, 2019 in Chengdu, and G6PD enzymology and gene detection were used for the diagnosis of 213 infants with positive screening results.@*RESULTS@#Among the 54 025 preterm infants, 192 were diagnosed with G6PD deficiency, with an incidence rate of 3.55‰. The incidence rate of G6PD deficiency in preterm infants was higher than that in full-term infants in the same period of time and tended to increase year by year. Birth in summer, gestational age T mutation tend to have mild conditions.


Subject(s)
China/epidemiology , Female , Genetic Testing , Glucosephosphate Dehydrogenase/genetics , Glucosephosphate Dehydrogenase Deficiency/genetics , Humans , Infant , Infant, Newborn , Infant, Premature , Mutation
4.
Brasília; Brasil. Ministério da Saúde; abr. 2020.
Non-conventional in Portuguese | LILACS, ColecionaSUS, BRISA | ID: biblio-1096175

ABSTRACT

OBJETIVO Esta nota técnica tem por objetivo apresentar uma avaliação técnica sobre a segurança da cloroquina e da hidroxicloroquina em pacientes com deficiência de glicose6-fosfato desidrogenase (G6PD), visando a fornecer subsídios para a recomendação sobre o rastreamento da deficiência de G6PD em pacientes elegíveis para tratamento com cloroquina ou hidroxicloroquina devido à infecção por coronavírus (COVID-19). DOS FATOS Trata-se de despacho emitido pelo Gabinete do Ministro da Saúde (0014309411) em 06 de abril de 2020, anexado ao processo 25000.048031/2020-24. O referido despacho apresenta um e-mail direcionado à Chefia de Gabinete do Ministro da Saúde, encaminhado pela profissional Dra. Silmara Paula Gouvea de Marco, vinculada à Universidade de São Paulo, intitulado "Problema Sério com Cloroquina". Neste, a autora da mensagem relata preocupação com o "efeito colateral de alto nível em pacientes com deficiência de G6PD ­ Anemia Hemolítica", sugerindo que "antes de ministrar o medicamento, laboratórios rastreiem a Def de G6PD, pois tais pacientes podem vir a óbito caso façam uso de tal medicamento", fazendo referência à utilização de cloroquina em pacientes com infecção por coronavírus (COVID-19). O processo foi recebido por esta coordenação em 13 de abril de 2020. DA ANÁLISE: Os medicamentos cloroquina e hidroxicloroquina foram recomendados pelo Ministério da Saúde como possibilidade terapêutica em pacientes com diagnóstico confirmado da COVID-19, hospitalizados e com a forma grave da doença, em caráter off label, ou seja, sem indicação prévia em bula. Ressalta-se que a sugestão do uso pode ser modificada a qualquer tempo, a depender dos resultados das pesquisas científicas em curso A bula da cloroquina informa sua contraindicação para pacientes com deficiência de glicose-6-fosfato desidrogenase e a bula da hidroxicloroquina adverte que seu uso nesses pacientes deve ser feito com cautela. A cloroquina é uma 4-aminoquinolina tradicionalmente recomendada como antimalárico. Quando administrada em combinação com primaquina (8-aminoquinolina), confere cura radical aos pacientes infectados por Plasmodium vivax. Estudos conduzidos com a primaquina na década de 1950 identificaram risco aumentado de anemia hemolítica em pacientes com deficiência de G6PD tratados com primaquina. CONCLUSÕES A cloroquina apresenta contraindicação em bula para pacientes com deficiência de G6PD e a bula da hidroxicloroquina recomenda uso com cautela nesses pacientes. Apesar disso, as evidências atualmente disponíveis não apontam para risco aumentado da utilização desses medicamentos em pacientes com deficiência de G6PD. Dessa forma, não se justifica o rastreamento de deficiência de G6PD em todos os pacientes elegíveis para tratamento com cloroquina ou hidroxicloroquina devido à infecção por coronavírus (COVID-19).


Subject(s)
Humans , Chloroquine/therapeutic use , Coronavirus Infections/drug therapy , Glucosephosphate Dehydrogenase Deficiency/diagnosis , Hydroxychloroquine/therapeutic use , Technology Assessment, Biomedical
5.
Article in Chinese | WPRIM | ID: wpr-828640

ABSTRACT

OBJECTIVE@#To investigate the current status of readmission of neonates with hyperbilirubinemia and risk factors for readmission.@*METHODS@#From January 2017 to December 2019, a total of 85 infants who were readmitted due to hyperbilirubinemia were enrolled as the study group. A total of 170 neonates with hyperbilirubinemia but without readmission during the same period of time were randomly selected as the control group. The medical data were compared between the two groups. Multivariate logistic regression was used to assess the risk factors for readmission due to hyperbilirubinemia.@*RESULTS@#The readmission rate was 2.30%, and the interval between readmission and initial admission was 5 days. Compared with the control group, the study group had significantly higher levels of total bilirubin and indirect bilirubin at discharge (P<0.05) and a significantly longer duration of phototherapy during the first hospitalization (P<0.05). The univariate analysis showed that compared with the control group, the study group had significantly lower birth weight, gestational age, and age on initial admission (P<0.05) and a significantly higher proportion of infants with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency or hemolytic disease (P<0.05). The multivariate analysis showed that low gestational age (OR=1.792, P<0.05), young age on initial admission (OR=1.415, P<0.05), and G-6-PD deficiency (OR=2.829, P<0.05) were independent risk factors for readmission of neonates with hyperbilirubinemia.@*CONCLUSIONS@#The infants with hyperbilirubinemia who have lower gestational age, younger age on initial admission, and G-6-PD deficiency have a higher risk of readmission due to hyperbilirubinemia. It is thus important to strengthen the management during hospitalization and after discharge for these infants to prevent the occurrence of readmission.


Subject(s)
Bilirubin , Glucosephosphate Dehydrogenase Deficiency , Humans , Hyperbilirubinemia, Neonatal , Infant, Newborn , Patient Readmission , Risk Factors
6.
Article in Chinese | WPRIM | ID: wpr-827172

ABSTRACT

OBJECTIVE@#To study the gene mutants of G6PD deficiency and their clinical featuers among children in Luzhou area.@*METHODS@#732 children with suspected G6PD deficiency in Luzhou area from March 2017 to July 2019 were selected, which were examined for G6PD enzyme activity and gene mutation. The G6PD enzyme activity was detected by ultraviolet rate quantification, and the gene mutation was detected by melting curve analysis-based PCR assay, and the clinical characteristics of different mutants when acute hemolysis happens were analyzed.@*RESULTS@#387 positive specimens were detected in 732 specimens, among which the gene mutation and the enzyme activity decrease was found in specimens 326, 49 specimens showed gene mutation but without the enzyme activity decrease, and 12 specimens without gene mutation but with the enzyme activity decrease. Among 375 positive samples with gene mutation, c.1376G>T, c.1388G>A, c.1024C>T and c.95A>G were the most common. The enzyme activity of c.1376G>T and c.1388G>A was statistically significantly different with c.1024C>T. The most common incentives of acute hemolysis was broad bean, the reticulocyte count was statistically significantly different among c.1376G>T, c.1388G>A and c.95A>G. The hemoglobin level of c.1376G>T was statistically significantly different from with c.95A>G. Moreover, c.1376G>T, c.1388G>A was lower than c.1024 C>T. When acute hemolysis occurs, the reticulocyte count and hemoglobin changes were different between different mutation types, while the patients age, hospitalization time, blood transfusion, total bilirubin, and urine color recovery time of the patients were not statistically different.@*CONCLUSION@#The common mutants of G6PD deficiency among children in Luzhou area are c.1376G>T, and c.1388G>A, c.1024C>T. Favism is the most common clinical manifestation of G6PD deficiency.


Subject(s)
Child , Glucosephosphate Dehydrogenase , Glucosephosphate Dehydrogenase Deficiency , Hemolysis , Humans , Mutation
7.
Arch. argent. pediatr ; 117(4): 267-270, ago. 2019. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1054935

ABSTRACT

La deficiencia de glucosa-6-fosfato deshidrogenasa es la enzimopatía eritrocitaria causada por mutaciones en el gen G6PD, cuya herencia está ligada al cromosoma X. Se analizan las características clínicas y de laboratorio de 24 individuos con deficiencia de G6PD durante 25 años. La edad mediana al momento del diagnóstico fue 10,2 años (rango: 0,6-56,4). El 54,2 % de los pacientes fueron asintomáticos, mientras que el 25 % presentó anemia hemolítica crónica no esferocítica; el 12,5 %, ictericia neonatal y anemia hemolítica posinfecciones, y el 8,3 %, anemia hemolítica aguda pos ingesta de habas. Los 24 pacientes estudiados presentaron variantes descritas previamente en la literatura. Las características clínicas observadas estuvieron acordes con las variantes encontradas. Veintiuna mujeres, pertenecientes a la rama materna de los individuos afectados, pudieron ser identificadas por biología molecular como portadoras de la deficiencia, por lo que recibieron el consejo genético correspondiente.


Glucose-6-phosphate dehydrogenase deficiency is an erythrocyte enzyme disorder caused by mutations in the G6PD gene, which has an X-linked inheritance. Here we analyze the clinical and laboratory characteristics of 24 subjects with G6PD deficiency over 25 years. Their median age at diagnosis was 10.2 years (range: 0.6-56.4). No symptoms were observed in 54.2 % of patients, whereas 25 % had chronic non-spherocytic hemolytic anemia; 12.5 %, neonatal jaundice and postinfectious hemolytic anemia; and 8.3 %, acute hemolytic anemia after ingestion of fava beans. The 24 studied patients had variants that had been previously described in the bibliography. The clinical characteristics observed here were consistent with the variants found. A total of 21 women from the maternal line of affected subjects were identified as deficiency carriers using molecular biology techniques, so they received the corresponding genetic counseling.


Subject(s)
Humans , Male , Female , Child , Diagnosis , Glucosephosphate Dehydrogenase Deficiency , Metabolism, Inborn Errors , Molecular Biology
8.
Hist. ciênc. saúde-Manguinhos ; 26(1): 245-264, Jan.-Mar. 2019.
Article in English | LILACS | ID: biblio-989863

ABSTRACT

Abstract This paper focuses on geneticists Salvador Armendares's and Rubén Lisker's studies from the 1960s to the 1980s, to explore how their work fits into the post-1945 human biological studies, and also how the populations they studied, child and indigenous, can be considered laboratories of knowledge production. This paper describes how populations were considered for different purposes: scientific inquiry, standardization of medical practices, and production or application of medicines. Through the narrative of the different trajectories and collaborations between Armendares and Lisker, this paper also attempts to show the contact of their scientific practices, which brought cytogenetics and population genetics together at the local and global levels from a transnational perspective.


Resumo Aborda o trabalho dos geneticistas Salvador Armendares e Rubén Lisker, entre 1960 e 1980, para analisar como se insere nos estudos biológicos humanos do pós-1945, e demonstra como as populações estudadas por eles, a infantil e a indígena, podem ser consideradas laboratórios de produção de conhecimento. O artigo revela como as populações foram consideradas para diversos propósitos: investigação científica, padronização das práticas médicas e produção ou aplicação de suas medicinas. Por meio da narrativa das diferentes trajetórias e colaborações entre Armendares e Lisker, também procura discutir o contato de suas práticas científicas, que colocaram a citogenética e a genética de populações lado a lado nos níveis local e global a partir de uma perspectiva transnacional.


Subject(s)
Humans , Child , History, 20th Century , Human Genetics/history , Indigenous Peoples/history , Genetics, Population/history , Carbohydrate Metabolism, Inborn Errors/history , Cytogenetics/history , Lactase/deficiency , Lactase/history , Indigenous Peoples/genetics , Glucosephosphate Dehydrogenase Deficiency/history , Karyotyping/history , Mexico
9.
Article in French | AIM | ID: biblio-1264281

ABSTRACT

Le paludisme reste un problème majeur de santé publique en Afrique subsaharienne, notamment au Niger où il sévit sur un mode endémique. Un des éléments de gravité est la survenue d'une hémoglobinurie et/ou une anémie. Nous rapportons 5 observations d'anémie par déficit en glucose-6-phosphatase (G6PD) de diagnostic tardif, car mis dans le compte du paludisme grave. Il s'agissait de cinq enfants d'âge moyen de 8,2 ans. 3 des patients étaient de sexe masculin. Tous les cinq patients étaient admis en urgence, référés pour anémie sévère dans un contexte de fièvre. Le nombre moyen d'hospitalisations antérieures était de 4. Les principaux signes à l'admission étaient la pâleur, les douleurs abdominales et des urines couleur porto. La bandelette urinaire a révélé une hémoglobinurie chez tous les patients et une bilirubinurie dans 4 cas. Une notion d'ictère a été retrouvée chez 2 patients, les 3 autres présentaient un ictère clinique. Le taux d'hémoglobine moyen était de 4,4 g/dl. Le taux des plaquettes et le taux de réticulocytes étaient normaux. La goutte épaisse était positive chez tous les patients. Le profil électrophorétique de l'hémoglobine était hétérozygote AS dans 2 cas et homozygote AA dans 3 cas. L'activité enzymatique de la G6PD, dosée à distance de la crise, était effondrée chez tous les patients. Le déficit en G6PD constituant une cause fréquente d'hémoglobinurie et/ou d'anémie chez l'enfant, le bilan étiologique, surtout devant la récurrence de ces signes, devrait en outre comporter un dosage de l'activité enzymatique de la G6PD


Subject(s)
Case Reports , Child , Glucosephosphate Dehydrogenase Deficiency , Hemoglobinuria , Malaria , Niger
10.
Einstein (Säo Paulo) ; 17(1): eAO4436, 2019. tab, graf
Article in English | LILACS | ID: biblio-975113

ABSTRACT

ABSTRACT Objective To evaluate the prevalence of G6PD deficiency and characterize G202A, A376G and C563T polymorphisms in neonates using molecular assays. Methods A total of one thousand samples were tested through quantitative analysis of enzyme activity, detecting 25 G6PD-deficient individuals. Patients identified as deficient were submitted to molecular analysis quantitative real-time polymerase chain reaction - (qPCR) to investigate the presence of variants associated with the deficiency. Results The total prevalence of G6PD deficient was 2.5%. Of the 25 samples identified as deficient, 21 were submitted to qPCR assay to analyze the presence of G202A, A376G and C563T variants. All samples showed the G202A/A376G genotype, characterizing G6PD A- phenotype. Conclusion The prevalence of G6PD deficiency in the present study was similar to that observed in other study populations in Brazil. Molecular analysis identified in all patients the presence of the genetic polymorphism G202A/A376G, more common in the Brazilian population with G6PD deficiency, which is directly estimated by enzyme activity level.


RESUMO Objetivo Avaliar a prevalência da deficiência de G6PD e caracterizar, por ensaios moleculares, os polimorfismos G202A, A376G e C563T em recém-nascidos. Métodos Foram testadas mil amostras por meio da análise quantitativa da atividade enzimática, detectando 25 portadores de deficiência de G6PD. Os pacientes identificados como deficientes foram submetidos à análise molecular reação em cadeia da polimerase em tempo real (qPCR) para pesquisa da presença das variantes associadas à deficiência. Resultados A prevalência total de deficientes de G6PD foi de 2,5%. Das 25 amostras identificadas como deficientes, 21 foram submetidas ao qPCR, para análise da presença das variantes G202A, A376G e C563T. Todas as amostras apresentaram o genótipo G202A/A376G, caracterizando fenótipo G6PD A-. Conclusão A prevalência da deficiência da G6PD no presente estudo foi semelhante à verificada em outras populações de estudo no Brasil. A análise molecular identificou em todos os pacientes a presença do polimorfismo genético G202A/A376G, mais comum na população brasileira portadora da deficiência de G6PD, que é diretamente estimada pelo nível de atividade enzimática.


Subject(s)
Humans , Male , Female , Infant , Polymorphism, Genetic/genetics , Glucosephosphate Dehydrogenase Deficiency/genetics , Glucosephosphate Dehydrogenase Deficiency/epidemiology , Phenotype , Brazil/epidemiology , Prevalence , Sex Distribution , Real-Time Polymerase Chain Reaction , Genotype
11.
Rev. cuba. med. gen. integr ; 34(3)jul.-set. 2018.
Article in Spanish | LILACS, CUMED | ID: biblio-1093457

ABSTRACT

Introducción: La presencia de ictericia en la práctica clínica generalmente hace sospechar problemas hepáticos o de vías biliares, siendo el íctero de causa hemolítica menos frecuente. Objetivo: Presentar un caso de íctero hemolítico infrecuente. Caso clínico: Paciente femenina de 47 años que presenta episodio de íctero hemolítico después de la ingestión de medicamentos. Los estudios de función hepáticos fueron normales. Se sospecha y diagnostica déficit de glucosa 6 fosfato deshidrogenasa variante electroforética A-. Conclusiones: Ante la presencia de íctero deben sospecharse posibles causas no hepáticas, como el déficit de glucosa 6 fosfato deshidrogenasa(AU)


Introduction: The presence of jaundice in clinical practice usually causes suspicion of liver or bile duct problems, but hemolytic icterus is a less frequent cause. Objective: To present a case of infrequent hemolytic icterus. Clinical case: A 47-year-old female patient who presented an episode of hemolytic icterus after medication ingestion. Liver function studies were normal. Suspected and diagnosed glucose 6-phosphate dehydrogenase deficiency, electrophoretic variant A-. Conclusions: In the presence of icterus, possible non-hepatic causes should be suspected, such as glucose 6-phosphate dehydrogenase deficiency(AU)


Subject(s)
Humans , Glucosephosphate Dehydrogenase Deficiency , Hemolysis , Jaundice/epidemiology
12.
Article in Chinese | WPRIM | ID: wpr-775824

ABSTRACT

OBJECTIVE@#To determine the incidence and genotypes of glucose-6-phosphate dehydrogenase (G6PD) deficiency in Dongguan region of Guangdong Province and assess the efficacy and feasibility of flow-through hybridization.@*METHODS@#Peripheral blood samples were randomly selected and detected by modified G6PD/6PGD ratio method. Flow-through hybridization was used to detect 14 G6PD mutations among all samples.@*RESULTS@#In total 1005 samples were collected, the detection rate for modified G6PD/6PGD ratio method and flow-through hybridization were 2.79% and 20.90%, respectively. The consistency of the two methods was poor(Kappa=0.187). When c.1311C>T mutation is excluded, the consistency of the two methods was good for males (Kappa=0.952) but still poor for females (Kappa=0.194). The most common mutations were c.1376G>T, c.1388G>A and c.95A>G. No G6PD deficiency was found among those only carrying the c.1311C>T mutation.@*CONCLUSION@#Flow-through hybridization can simultaneously detect 14 loci, covering over 90% of common mutations in Chinese population, and can be easily expanded. The routine method may miss many females carrying homozygous, compound heterozygous and heterozygous mutations, but the detection rate for male hemizygous mutation was much higher.


Subject(s)
China , DNA Mutational Analysis , Female , Genetic Testing , Genotype , Glucosephosphate Dehydrogenase , Genetics , Glucosephosphate Dehydrogenase Deficiency , Diagnosis , Humans , Male , Mutation
13.
Journal of Experimental Hematology ; (6): 1649-1656, 2018.
Article in Chinese | WPRIM | ID: wpr-773041

ABSTRACT

OBJECTIVE@#To explore the change of G6PD activity in children with acute leukemia(AL)and its correlation with the clinical characteristics.@*METHODS@#The G6PD activity in peripheral blood samples from 74 children disagnosed as AL (50 cases of ALL, and 24 cases of AML) was detected by Zinkham method recommended by WHO in 1967, and its relevance with clinical indicators was statistically analyzed. The peripheral blood samples of 70 healthy children were used as the controls.@*RESULTS@#The G6PD activity in ALL and AML groups was significantly lower than that in the control group (P=0.000, P=0.000) and there was no statistical difference between ALL and AML groups. The G6PD activity in bacterial, fungal infection and non-infection groups (no bacterial and fungal infection) were statistically different from control group (P=0.02, P=0.001, P=0.001), respectively. The G6PD activity in bacterial infection group and non-infection group was statistically different from with fungal infection group (P=0.004, P=0.019), respectively. The G6PD activity linearly correlated with leukocyte count and neutrophil percentage in AL children (P=0.000, P=0.001, r=0.465, r=0.434), respectively. The median survival time of G6PD activity deficiency group was higher than that in the normal group, but without statistically significant difference (P=0.4149).@*CONCLUSION@#The G6PD activity in AL children is significantly lower than that in healthy children, and the G6PD activity linearly relates with leukocyte count and neutrophil percentage of AL children. The patients with G6PD activity deficiency is more susceptible to fungal infection, moreover the infection is more serious.


Subject(s)
Acute Disease , Bacterial Infections , Child , Glucosephosphate Dehydrogenase , Glucosephosphate Dehydrogenase Deficiency , Humans , Leukemia, Myeloid, Acute , Neutrophils
15.
Article in English | LILACS | ID: biblio-1043313

ABSTRACT

ABSTRACT The aim of this study has been to study whether the top-down method, based on the average value identified in the Brazilian Hospitalization System (SIH/SUS), is a good estimator of the cost of health professionals per patient, using the bottom-up method for comparison. The study has been developed from the context of hospital care offered to the patient carrier of glucose-6-phosphate dehydrogenase (G6PD) deficiency with severe adverse effect because of the use of primaquine, in the Brazilian Amazon. The top-down method based on the spending with SIH/SUS professional services, as a proxy for this cost, corresponded to R$60.71, and the bottom-up, based on the salaries of the physician (R$30.43), nurse (R$16.33), and nursing technician (R$5.93), estimated a total cost of R$52.68. The difference was only R$8.03, which shows that the amounts paid by the Hospital Inpatient Authorization (AIH) are estimates close to those obtained by the bottom-up technique for the professionals directly involved in the care.


RESUMO A pesquisa teve por objetivo estudar se o macrocusteio, baseado no valor médio identificado no Sistema de Internação Hospitalar (SIH/SUS), constitui um bom estimador do custo de profissionais de saúde por paciente, tendo como comparação o método de microcusteio. O estudo foi desenvolvido no contexto da assistência hospitalar oferecida ao portador da deficiência de glicose-6-fosfato desidrogenase (dG6PD) do sexo masculino com evento adverso grave devido ao uso da primaquina, na Amazônia Brasileira. O macrocusteio baseado no gasto em serviços profissionais do SIH/SUS, como proxy desse custo, correspondeu a R$60,71, e o microcusteio, baseado nos salários do médico (R$30,43), do enfermeiro (R$16,33) e do técnico de enfermagem (R$5,93), estimou um custo total de R$52,68. A diferença foi de apenas R$8,03, mostrando que os valores pagos pela Autorização de Internação Hospitalar (AIH) são estimadores próximos daqueles obtidos por técnica de microcusteio para os profissionais envolvidos diretamente no cuidado.


Subject(s)
Humans , Male , Adult , Primaquine/adverse effects , Hospital Costs/statistics & numerical data , Glucosephosphate Dehydrogenase Deficiency/economics , Glucosephosphate Dehydrogenase Deficiency/drug therapy , Hospitalization/economics , Antimalarials/adverse effects , Patient Care Team/economics , Primaquine/economics , Time Factors , Brazil , Malaria/diet therapy , Malaria/economics , National Health Programs/economics , Antimalarials/economics
16.
Article in English | WPRIM | ID: wpr-145724

ABSTRACT

The authors describe the successful perioperative management of a 3-year-old boy from Dubai with glucose-6-phosphate dehydrogenase (G6PD) deficiency, who underwent robot-assisted laparoscopic pyeloplasty for complete right ureteropelvic junction obstruction. G6PD deficiency is a genetic disorder predisposing patients to hemolytic anemia from oxidative stress. Important considerations in anesthetic management include avoiding oxidative stress, which can be caused by various conditions, and monitoring for hypercapnia, which can cause acidosis and hemolysis. Laparoscopic surgery is usually associated with hypercapnia and therefore an increased risk for respiratory acidosis. During surgery in this particular case, efforts were made to avoid carbon dioxide retention and to keep the patient warm. General anesthesia was induced with thiopental sodium, rocuronium, and fentanyl, and maintained with sevoflurane. There were no signs of hemolysis in the perioperative period and he was discharged owing to his improved condition.


Subject(s)
Acidosis , Acidosis, Respiratory , Anemia, Hemolytic , Anesthesia, General , Carbon Dioxide , Child, Preschool , Fentanyl , Glucose-6-Phosphate , Glucosephosphate Dehydrogenase Deficiency , Glucosephosphate Dehydrogenase , Hemolysis , Humans , Hypercapnia , Laparoscopy , Male , Oxidative Stress , Perioperative Period , Thiopental
17.
Article in English | WPRIM | ID: wpr-50098

ABSTRACT

PURPOSE: This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus. METHODS: This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2007 and June 2010 were reviewed. Data on sex, age at presentation, hospitalization duration, need for ET, hemoglobin (Hb) level, reticulocyte count, direct Coombs test, serum total and indirect bilirubin levels, thyroid function, blood and urine cultures, G6PD status, and blood groups were collected and compared between the G6PD-deficent and G6PD-normal patients. RESULTS: Of 1,159 NIH patients admitted, 1,129 were included, of whom 646 (57%) were male. Among 1,046 patients tested, 442 (42%) were G6PD deficient, 49 (4%) needed ET, and 11 (1%) had suspected Kernicterus. The G6PD-deficient patients were mainly male (P<0.0001), and had lower Hb levels (P<0.0001) and higher maximum bilirubin levels (P=0.001). More G6PD-deficient patients needed ET (P<0.0001). G6PD deficiency (P=0.006), lower Hb level (P=0.002), lower hematocrit count (P=0.02), higher bilirubin level (P<0.0001), higher maximal bilirubin level (P<0.0001), and positive blood culture result (P<0.0001) were significant risk factors for ET. Maximal bilirubin level was a significant risk factor for kernicterus (P=0.021) and independently related to ET (P=0.03). CONCLUSION: G6PD deficiency is an important risk factor for severe NIH. In G6PD-deficent neonates, management of NIH should be hastened to avoid irreversible neurological complications.


Subject(s)
Bahrain , Bilirubin , Blood Group Antigens , Case-Control Studies , Coombs Test , Glucose-6-Phosphate , Glucosephosphate Dehydrogenase Deficiency , Glucosephosphate Dehydrogenase , Hematocrit , Hospitalization , Humans , Hyperbilirubinemia , Hyperbilirubinemia, Neonatal , Infant , Infant, Newborn , Kernicterus , Male , Medical Records , Prevalence , Reticulocyte Count , Retrospective Studies , Risk Factors , Thyroid Gland
18.
Article in English | WPRIM | ID: wpr-8653

ABSTRACT

BACKGROUND: We describe the genetic profiles of Korean patients with glucose-6-phosphate dehydrogenase (G6PD) deficiencies and the effects of G6PD mutations on protein stability and enzyme activity on the basis of in silico analysis. METHODS: In parallel with a genetic analysis, the pathogenicity of G6PD mutations detected in Korean patients was predicted in silico. The simulated effects of G6PD mutations were compared to the WHO classes based on G6PD enzyme activity. Four previously reported mutations and three newly diagnosed patients with missense mutations were estimated. RESULTS: One novel mutation (p.Cys385Gly, labeled G6PD Kangnam) and two known mutations [p.Ile220Met (G6PD São Paulo) and p.Glu416Lys (G6PD Tokyo)] were identified in this study. G6PD mutations identified in Koreans were also found in Brazil (G6PD São Paulo), Poland (G6PD Seoul), United States of America (G6PD Riley), Mexico (G6PD Guadalajara), and Japan (G6PD Tokyo). Several mutations occurred at the same nucleotide, but resulted in different amino acid residue changes in different ethnic populations (p.Ile380 variant, G6PD Calvo Mackenna; p.Cys385 variants, Tomah, Madrid, Lynwood; p.Arg387 variant, Beverly Hills; p.Pro396 variant, Bari; and p.Pro396Ala in India). On the basis of the in silico analysis, Class I or II mutations were predicted to be highly deleterious, and the effects of one Class IV mutation were equivocal. CONCLUSIONS: The genetic profiles of Korean individuals with G6PD mutations indicated that the same mutations may have arisen by independent mutational events, and were not derived from shared ancestral mutations. The in silico analysis provided insight into the role of G6PD mutations in enzyme function and stability.


Subject(s)
Asians/genetics , Child , Child, Preschool , DNA/chemical synthesis , Exons , Glucosephosphate Dehydrogenase/chemistry , Glucosephosphate Dehydrogenase Deficiency/genetics , Humans , Male , Mutation, Missense , Polymorphism, Genetic , Protein Structure, Tertiary , Republic of Korea , Sequence Analysis, DNA
19.
Article in English | WPRIM | ID: wpr-54503

ABSTRACT

OBJECTIVE: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect. G6PD plays a key role in the pentose phosphate pathway, which is a major source of nicotinamide adenine dinucleotide phosphate (NADPH). NADPH provides the reducing equivalents for oxidation-reduction reductions involved in protecting against the toxicity of reactive oxygen species such as H₂O₂. We hypothesized that G6PD deficiency may reduce the amount of NADPH in sperms, thereby inhibiting the detoxification of H₂O₂, which could potentially affect their motility and viability, resulting in an increased susceptibility to infertility. METHODS: Semen samples were obtained from four males with G6PD deficiency and eight healthy males as a control. In both groups, motile sperms were isolated from the seminal fluid and incubated with 0, 10, 20, 40, 60, 80, and 120 µM concentrations of H2O2. After 1 hour incubation at 37℃, sperms were evaluated for motility and viability. RESULTS: Incubation of sperms with 10 and 20 µM H₂O₂ led to very little decrease in motility and viability, but motility decreased notably in both groups in 40, 60, and 80 µM H₂O₂, and viability decreased in both groups in 40, 60, 80, and 120 µM H₂O₂. However, no statistically significant differences were found between the G6PD-deficient group and controls. CONCLUSION: G6PD deficiency does not increase the susceptibility of sperm to oxidative stress induced by H₂O₂, and the reducing equivalents necessary for protection against H₂O₂ are most likely produced by other pathways. Therefore, G6PD deficiency cannot be considered as major risk factor for male infertility.


Subject(s)
Glucose-6-Phosphate , Glucosephosphate Dehydrogenase Deficiency , Glucosephosphate Dehydrogenase , Humans , Infertility , Infertility, Male , Male , NADP , Oxidation-Reduction , Oxidative Stress , Pentose Phosphate Pathway , Reactive Oxygen Species , Risk Factors , Semen , Spermatozoa
20.
Article in Chinese | WPRIM | ID: wpr-287957

ABSTRACT

<p><b>OBJECTIVE</b>To determine the incidence and molecular characteristics of G6PD deficiency in Chaozhou region of eastern Guangdong Province.</p><p><b>METHODS</b>G6PD enzyme activity was assayed with an auto-bioanalyzer. Reverse dot blotting (RDB) was used for detecting 6 common G6PD mutations. Samples with no mutation detected by RDB were further sequenced for unknown mutations.</p><p><b>RESULTS</b>The rate of G6PD deficiency was 3.36% (142/4224). 2.33% (47/2013) of males and 4.3% (95/2208) of females were affected. 12 mutations were detected among the 142 patients, which included c.1376G>T, c.1388G>A, c.1024C>T, c.392G>T, c.871G>A, c.95A>G, c.517T>C, c.131C>G, c.1376G>T/c.517T>C, c.871G>A/IVS-1193T>C/c.1311C>T, c.1376G>T/IVS-11, 93T>C/c.1311C>T and c.1376G>T/c.486_34delT (rs3216174).</p><p><b>CONCLUSION</b>The incidence of G6PD deficiency in Chaozhou region was lower than that of the Hakka population of Guangdong Province, and the mutation types were diversely distributed in this region. c.1376G>T, c.1388G>A and c.1024C>T were the most common mutations, which was followed by c.517T>C. In addition, c.131C>G has been first discovered in the Chinese population. c.1376G>T/c.517T>C and c.1376G>T/c.486_34delT(rs3216174) were new types of compound heterozygous mutations in females.</p>


Subject(s)
Adolescent , Base Sequence , China , Epidemiology , Ethnology , Female , Genotype , Glucosephosphate Dehydrogenase , Genetics , Glucosephosphate Dehydrogenase Deficiency , Epidemiology , Ethnology , Genetics , Humans , Incidence , Male , Molecular Epidemiology , Molecular Sequence Data , Mutation
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