ISSN 2997-1036
International Journal of Hematology | Vol. 7, No. 6, June 2016 | pp. 41–48
DOI: 10.46882/2016/IJH/000078
Original Article
Title: Evaluation of cell-free hemoglobin and haptoglobin consumption dynamics as hemolytic severity indices in glucose-6-phosphate dehydrogenase deficiency
Names of Authors: Q. S. Abubakar¹, U. T. Maina²
Authors’ Affiliations: ¹Department of Haematology, National Hospital, Abuja, Nigeria; ²Department of Pathology, Bayero University, Kano, Nigeria
Abstract: Acute hemolytic crises in glucose-6-phosphate dehydrogenase (G6PD) deficiency can be triggered by oxidative stress from infections or drugs, requiring quantitative monitoring metrics. This prospective study evaluated plasma cell-free hemoglobin, serum haptoglobin concentrations, and total bilirubin variations in 45 male children presenting with acute hemolytic anemia secondary to confirmed glucose-6-phosphate dehydrogenase deficiency. Parameters were monitored during the acute phase (days 1 to 3) and following clinical recovery at day 14. Mean baseline cell-free hemoglobin was markedly elevated during the acute phase (142.5 ± 24.5 mg/dl) compared to post-recovery values (8.4 ± 2.1 mg/dl, P < 0.001). Concurrently, serum haptoglobin levels were completely suppressed (< 10 mg/dl) in 88.8% of the children, indicating massive intravascular hemolysis and haptoglobin saturation. Cell-free hemoglobin levels correlated positively with the absolute drop in total hemoglobin (r = 0.62, P < 0.01) and served as a superior index for identifying children at high risk for acute kidney injury. Quantifying plasma cell-free hemoglobin levels helps clinicians monitor hemolytic severity and manage fluid balancing during oxidative crises.
Keywords: Glucose-6-phosphate dehydrogenase, acute hemolysis, cell-free hemoglobin, haptoglobin, oxidative stress
Manuscript Timeline: Received: March 20, 2016; Revised: April 28, 2016; Accepted: May 15, 2016; Published: June 18, 2016