HEMOLYSIS AFTER ACETAMINOPHEN OVERDOSE IN A PATIENT WITH GLUCOSE-6-PHOSPHATE-DEHYDROGENASE DEFICIENCY

Case Report: A sixteen year-old-male with a history of glucose-6-phosp hate dehydrogenase deficiency ingested an unknown amount of acetaminop hen and presented to an emergency department 7.5 h later. He was afebr ile. His serum acetaminophen level was 184 mu g/mL, and his urine toxi cologic screen was otherwise negative. Vomiting led to enrollment in a experimental protocol of intravenous N-acetylcysteine. He developed n o evidence of subsequent chemical hepatitis but did develop a signific ant Coomb's negative hemolytic anemia. Hemoglobin on presentation was 14 g/dL and reached a nadir of 9.4 g/dL on admission day 4. Conclusion : Patients with glucose-6-phosphate dehydrogenase deficiency who overd ose with acetaminophen should be monitored for the possible developmen t of subsequent drug-induced hemolysis.