hemolysis trigger in glucose-6-phosphate dehydrogenase enzyme deficiency vicia sativa [Vetch]

Glucose-6-phosphate dehydrogenase [G6PD] is an enzyme, playing an important role in the redox metabolism of all aerobic cells. It was reported that certain medications, fava beans, and infections can trigger acute hemolytic anemia in patients with G6PD deficiency. An 8-year-old male patient was admitted to the hospital with blood in the urine, headache, dizziness, fatigue, loss of appetite, and jaundice in the eyes, 24 hours after eating large amounts of fresh, vetch grains. Laboratory investigation revealed hemolytic anemia, hyperbilirubinemia, and G6PD deficiency. Approximately 0.5% of fava bean seeds have 2 pyrimidine beta-glycosides called, vicine and convicine. Vetch has 0.731% vicine, 0.081% convicine, and 0.530% beta cyanoalanine glycosides. The aim of this case report is to emphasize the importance of vetch seeds as a cause for hemolytic crisis in our country, where approximately one million tons of vetch is produced per year, especially in the agricultural regions

relationship of hypocalcemic convulsions related to nutritional rickets with age, gender, season, and serum phosphorus levels

To retrospectively evaluate the epidemic characteristics of children with hypocalcemic convulsion related to nutritional rickets in the province of Kars, Turkey. In this study, clinical and laboratory findings of 93 infants, aged between 1-24 months, who were diagnosed as hypocalcemic convulsive resulting from nutritional rickets between January 2000 and June 2005 in Kars Maternity and Child Hospital, were investigated. The data of the cases with hypocalcemic convulsive rickets were collected from the hospital archive file. The mean and median ages of the cases were 8.93 and 6 [1-24] months, and 66 [71%] were male. Most of the patients were admitted to hospital in February and March, whereas 46% were admitted in winter, 44% in spring, 8% in autumn, and 2% in summertime. Serum calcium levels of all cases were low [mean: 5.4 +/- 0.84 mg/dl] and serum alkaline phosphate levels were high [mean: 1286 +/- 528 IU/L], while serum phosphorus levels were low in 19 [20.4%], high in 8 [8.6%], and normal in 66 [71%] patients. While evaluating the causes of convulsion, hypocalcemic convulsion related to nutritional rickets should be considered among the causes as well as age, gender, and season of the year, and diagnosis, and treatment should be initiated without delay. In addition, serum phosphorus level should also be questioned in the diagnosis of nutritional rickets