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Aspirin-induced acute haemolytic anaemia in glucose-6-phosphate dehydrogenase-deficient children with systemic
T Meloni1, G Forteleoni, A Ogana
1Clinica Pediatrica A. Filia, Università di Sassari, Italia.
Insights
Aspirin (acetylsalicylic acid) triggered severe hemolytic anemia in a child with glucose-6-phosphate dehydrogenase deficiency and systemic arthritis. This aspirin-induced anemia, characterized by erythrocyte fragmentation, highlights a critical drug-induced complication.
Area of Science:
- Hematology
- Pediatrics
- Pharmacology
Background:
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited condition affecting red blood cells.
- Systemic arthritis can present with complex clinical manifestations in children.
- Acetylsalicylic acid is a common nonsteroidal anti-inflammatory drug.
Observation:
- A 4-year-old boy with G6PD deficiency and systemic arthritis developed severe hemolytic anemia.
- Peripheral blood smears revealed erythrocyte fragmentation, a hallmark of red blood cell damage.
- Laboratory data excluded infectious causes for the anemia.
Findings:
- The severe hemolytic anemia was directly linked to the administration of acetylsalicylic acid (aspirin).
- The observed erythrocyte fragmentation pattern is consistent with drug-induced hemolysis in G6PD deficient individuals.
- Aspirin precipitated a significant hemolytic crisis in this pediatric patient.
Implications:
- Clinicians should exercise caution when prescribing aspirin to pediatric patients with G6PD deficiency.
- Understanding drug-induced hemolytic anemia is crucial for managing patients with G6PD deficiency.
- This case underscores the importance of considering medication history in unexplained hemolytic anemia.
Abstract:
In a 4-year 7-month-old boy with glucose-6-phosphate dehydrogenase deficiency and systemic arthritis a severe haemolytic anaemia occurred after the administration of acetylsalicylic acid. Erythrocyte fragmentation, with haemoglobin condensation zones next to clear zones, was observed on peripheral blood smears. Since viral or bacterial infections were excluded on the basis of the laboratory data, the anaemia was ascribed to aspirin.