A 7-year-old child from West Bengal presented with high grade fever with chills and rigor. Peripheral smear examination revealed Plasmodium vivax. He was given treatment for the same. But he again presented with jaundice, and a repeat peripheral smear showed following. What is your diagnosis?
High-Yield Explanation
- Peripheral smear showing 'bite cells' after treatment with anti-malarials - suggests G6PD deficiency. G6PD deficiency: X-linked recessive disorder. Most common red cell enzyme deficiency. Hemolysis is seen d/t raised oxidative stress. FEATURES: Pallor, icterus, hemoglobinemia, hemoglobinuria, splenomegaly etc are seen Heinz bodies are seen DRUGS CAUSING OXIDATIVE STRESS IN THESE PATIENTS: Sulfonamides - sulfamethoxazole Anti-malarials - Primaquine, quinine Analgesics - Aspirin, NSAIDS, phenazopyridine (pyridium) Others - Nitrofurantoin, Dapsone, Methylene blue, Rasburicase, Toluidine blue, Nalidixic acid, Furazolidine, quinidine