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CLINICAL CASE REPORT
Year : 2020  |  Volume : 33  |  Issue : 3  |  Page : 149-151

Automated-red cell exchange for methaemoglobinaemia in a G6PD-deficient patient


1 Department of Transfusion Medicine, Medanta-The Medicity, Sector 38, Gurugram 122001, Haryana, India
2 Department of Internal Medicine, Medanta-The Medicity, Sector 38, Gurugram 122001, Haryana, India

Correspondence Address:
Aseem K Tiwari
Department of Transfusion Medicine, Medanta-The Medicity, Sector 38, Gurugram 122001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-258X.314007

Methaemoglobinaemia in G6PD deficiency can be managed by oxidizing agents such as methylene blue and red cell exchange (RCE). We describe a G6PD-deficient patient who presented with oxidative stress with methaemoglobinaemia and was successfully managed with automated-RCE. At presentation, the patient had anaemia, was restless, was tired and had dyspnoea. Co-oximetry showed methaemoglo-binaemia of 10.1 U/g. Further testing revealed the patient had insufficient quantities of G6PD enzyme activity (0.1 U/g Hb). In view of methaemoglobinaemia, severe G6PD deficiency and signs of haemolysis, therapeutic RCE was planned. The patient underwent two automated-RCE procedures on consecutive days, bringing down his methaemoglobin levels from 12.5 to 0.1 U/g. In each procedure, 1.5 volumes of RCE at 100% balance rate was performed using 5 units of red blood cells. The patient responded well to RCE and other supportive treatment and was off medication and doing well at day 100 of follow-up.


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