RHABDOMYOLYSIS AND HEMOLYSIS ASSOCIATED WITH SICKLE-CELL TRAIT AND GLUCOSE-6-PHOSPHATE-DEHYDROGENASE DEFICIENCY

We report a case of severe oxidative hemolysis and rhabdomyolysis in a patient with sickle cell trait and glucose-6-phosphate dehydrogenase (G6PD) deficiency. The patient was a 34-year-old black man admitted 24 hours after vigorous exercise with myalgias, malaise, myoglobinuria, anemia, low haptoglobin, and a peripheral blood smear with bite cells consistent with oxidative hemolysis. He had two similar episodes withi n 21 months of the initial admission. Subsequent evaluation resulted i n the diagnosis of sickle cell trait and G6PD deficiency; muscle enzym e levels were normal. G6PD deficiency and sickle cell trait can be exp ected to occur simultaneously in up to 1% of black males. A second red blood cell defect should be considered when severe hemolysis is seen in a person with sickle cell trait.