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Glukoz-6-Fosfat Dehidrogenaz Eksikliği ve Talasemi Tașıyıcılığı Birlikteliğinde, Akut Hepatit-A Enfeksiyonunun Tetiklediği Anemi: Bir Olgu Sunumu

Year 2015, Yıl: 2015 Sayı: 1, 31 - 35, 01.03.2015

Abstract

Talasemi ve glukoz-6-fosfat dehidrogenaz (G6PD) eksikliği hemolitik anemiye neden olan genetik bozukluklardır. Her iki hematolojik bozukluğun yüksek sıklıkta görüldüğü bölgelerde talasemi ile G6PD eksikliğinin birlikte kalıtımı bulunabilir. Bununla beraber, enfeksiyonların hem talasemide ve hem de G6PD eksikliğinde hemolizi tetiklediği bilinmektedir. Amacım; hemoliz tetiklemesini akut hepatit A (HAV) virüsü enfeksiyonun yaptığını düșündüğüm hem G6PD eksikliği ve hem de talasemi tașıyıcısı olan bir hastayı sunmaktır. Üç yașındaki erkek hastada, solukluk, sarılık, büyüme-gelișme geriliği ve hepatosplenomegali tespit edildi. Hastada anemi, retikülosit yüksekliği (%6), periferik yaymada hedef hücre, idrarda hemoglobin (+++), idrar mikroskobisinde eritrosit negatifliği vardı. Hastanın HbA2, HbA ve HbF oranları sırasıyla %4,20, %76,1 ve %19,7’ydi. Babanın HbA2’si yüksek (%5,03), annenin HbA2’si ise normal (%2,65) olarak bulundu. Hastanın beta-globulin geni DNA dizi analizinde heterozigot codon 15G/A mutasyonu tespit edildi.Sonuç olarak; hepatit A enfeksiyonu olan hastalarda anemi ve belirgin hiperbilirubinemi varsa intravasküler hemoliz düșünülmeli, hastalıkların birlikte kalıtımı ihtimaline karșı periferik yayma (eritrosit morfolojisi) ve idrar mikroskobisi ihmal edilmemelidir.

Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report

Year 2015, Yıl: 2015 Sayı: 1, 31 - 35, 01.03.2015

Abstract

Thalassemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency are genetic disorders causing hemolytic anemia. Coinheritance of thalassemia and G6PD defi ciency can be present in regions where both hematological disorders have a high incidence. Infections may trigger hemolysis in both thalassemia and G6PD defi ciency. My aim is to present a patient with both G6PD deficiency and thalassemia trait where I believe the hemolysis was triggered by acute hepatitis A virus (HAV) infection. Pallor, jaundice, growth–development retardation and hepatosplenomegaly were found in a three-year-old male patient. Laboratory tests revealed anemia, reticulocyte elevation (6%), target cells inthe peripheral smear, (+++) hemoglobin in the urine and no erythrocyte on urine microscopy. The patient’s HbA2, HbA and HbF2 ratios were 4.20%, 76.10% and 19.7%, respectively. The father’s HbA2 was high (5.03%) while the mother’s HbA2 was normal(2.65%). A heterozygous codon 15G/A mutation was found in the patient’s beta-globulin gene DNA sequence analysis.In conclusion, intravascular hemolysis and coinheritance of different disorders must be considered and peripheral smear (erythrocyte morphology) and urine microscopy should not be neglected if anemia and signifi cant hyperbilirubinemia are present in patients with hepatitis A infection.

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Details

Other ID JA56JS38AC
Journal Section Case Report
Authors

Zafer Bıçakcı This is me

Publication Date March 1, 2015
Published in Issue Year 2015 Yıl: 2015 Sayı: 1

Cite

APA Bıçakcı, Z. (2015). Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report. Kafkas Journal of Medical Sciences(1), 31-35.
AMA Bıçakcı Z. Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report. KAFKAS TIP BİL DERG. March 2015;(1):31-35.
Chicago Bıçakcı, Zafer. “Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report”. Kafkas Journal of Medical Sciences, no. 1 (March 2015): 31-35.
EndNote Bıçakcı Z (March 1, 2015) Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report. Kafkas Journal of Medical Sciences 1 31–35.
IEEE Z. Bıçakcı, “Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report”, KAFKAS TIP BİL DERG, no. 1, pp. 31–35, March 2015.
ISNAD Bıçakcı, Zafer. “Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report”. Kafkas Journal of Medical Sciences 1 (March 2015), 31-35.
JAMA Bıçakcı Z. Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report. KAFKAS TIP BİL DERG. 2015;:31–35.
MLA Bıçakcı, Zafer. “Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report”. Kafkas Journal of Medical Sciences, no. 1, 2015, pp. 31-35.
Vancouver Bıçakcı Z. Acute Hepatitis-A Infection Induced Anemia in Concurrence of Glucose-6-Phosphate Dehydrogenase Deficiency and Thalassemia Trait: A Case Report. KAFKAS TIP BİL DERG. 2015(1):31-5.