Hydroxychloroquine in a G6PD-Deficient Patient with COVID-19 Complicated by Haemolytic Anaemia: Culprit or Innocent Bystander

  • François Mastroianni Department of Internal Medicine, EpiCURA Hospital, Hornu, Belgium
  • Vincent Colombie Department of Internal Medicine, EpiCURA Hospital, Hornu, Belgium
  • Géraldine Claes Department of Haematology, EpiCURA Hospital, Hornu, Belgium
  • Axelle Gilles Department of Haematology, EpiCURA Hospital, Hornu, Belgium
  • Frédéric Vandergheynst Department of Internal Medicine, Erasme Hospital, Brussels, Belgium
  • Sammy Place Department of Internal Medicine, EpiCURA Hospital, Hornu, Belgium
DOI: https://doi.org/10.12890/2020_001875

Keywords

Haemolytic anaemia, G6PD deficiency, COVID-19, SARS-CoV-2

Abstract

Hydroxychloroquine has been used worldwide as a first-line treatment for patients hospitalized with COVID-19. Little is known about COVID-19 and its effects on patients with congenital red blood cell disorders. We report a case of haemolytic anaemia in a 32-year-old patient and a fortuitous highlighting of G6PD deficiency. We reviewed the literature to assess the risk of hydroxychloroquine use in this context.

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References

  • Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061–1069.
  • Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020 Mar 9. doi: 10.1093/cid/ciaa237 [Epub ahead of print].
  • Gautret P, Lagier J-C, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020 Mar 20. doi: 10.1016/j.ijantimicag.2020.105949 [Epub ahead of print].
  • Cappellini MD, Fiorelli G. Glucose-6-phosphate dehydrogenase deficiency. Lancet 2008;371(9606):64–74.
  • Ho HY, Cheng ML, Weng SF, Chang L, Yeh TT, Shih SR, et al. Glucose-6-phosphate dehydrogenase deficiency enhances enterovirus 71 infection. J Gen Virol 2008;89:2080–2089.
  • Wu YH, Tseng CP, Cheng ML, Ho HY, Shih SR, Chiu DTY. Glucose-6-phosphate dehydrogenase deficiency enhances human coronavirus 229E infection. J Infect Dis 2008;197(6):812–816.
  • G6PD Deficiency Association website - Official drug list: https://www.g6pd.org/en/G6PDDeficiency/SafeUnsafe.aspx
  • Youngster I, Arcavi L, Schechmaster R, Akayzen Y, Popliski H, Shimonov J, et al. Medications and G6PD deficiency: an evidence-based review. Drug Saf 2010;33(9):713–726.
  • Mohammad S, Clowse MEB, Eudy AM, Criscione-Schreiber LG. Examination of hydroxychloroquine use and hemolytic anemia in G6PDH-deficient patients. Arthritis Care Res (Hoboken) 2018;70(3):481–485.
  • Mejia Saldarriaga M, Ramirez de Oleo IE, Johnson B. Retrospective study: association of hydroxychloroquine use and hemolytic anemia in patients with low levels of glucose-6- phosphate dehydrogenase (G6PD) [abstract]. Arthritis Rheumatol 2018;70(Suppl 10).
  • Beauverd Y, Adam Y, Assouline B, Samii K. COVID-19 infection and treatment with hydroxychloroquine cause severe haemolysis crisis in a patient with glucose-6-phosphate dehydrogenase deficiency. Eur J Haematol 2020 Apr 23. doi: 10.1111/ejh.13432 [Epub ahead of print].
  • Maillart E, Leemans S, Van Noten H, Vandergraesen T, Mahadeb B, Salaouatchi MT, et al. A case report of serious haemolysis in a glucose-6-phosphate dehydrogenase-deficient COVID-19 patient receiving hydroxychloroquine. Infect Dis (Lond) 2020 Jun 4. doi: 10.1080/23744235.2020.1774644 [Epub ahead of print].
  • Afra TP, Nampoothiri RV, Razmi TM. Doubtful precipitation of hemolysis by hydroxychloroquine in glucose-6-phosphate dehydrogenase deficient patient with COVID-19 infection. Eur J Haematol 2020 Jun 5. doi: 10.1111/ejh.13460 [Epub ahead of print].

    • Published: 2020-08-18

    Issue: Vol 7 No 9 (view)

    Section: Articles

    How to cite:
    1.
    Mastroianni F, Colombie V, Claes G, Gilles A, Vandergheynst F, Place S. Hydroxychloroquine in a G6PD-Deficient Patient with COVID-19 Complicated by Haemolytic Anaemia: Culprit or Innocent Bystander. EJCRIM 2020;7 doi:10.12890/2020_001875.

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