Infectious hepatitis and glucose-6-phosphate dehydrogenase deficiency

The occurrence of infectious hepatitis in patients with coexistent glucose-6-phosphate dehydrogenase (G6PD) deficiency may present a clinical picture similar to that of fulminant hepatitis. To determine the factors which enable a rapid diagnosis of this disease combination, the clinical and biochemical findings in 14 patients were compared with those in 50 patients with uncomplicated hepatitis and those in 14 patients with fulminant hepatitis. Similarities with the latter group included persistence of fever, tachycardia, leukocytosis and hyperbilirubinemia of greater than 340 mumol/liter (20 mg/dl). A rise in bilirubin values of more than 50 mumol/liter (3 mg/dl) per day in patients with viral hepatitis strongly suggested the presence of G6PD deficiency. Despite the severity of the illness, prothrombin activity was well maintained in G6PD-deficienct patients.