Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia

Methylene blue is an antidote for methaemoglobinaemia, but it is not given to individuals with glucose 6 phosphate dehydrogenase (G6PD) deficiency since it could potentially worsen oxidative haemolysis. We report the case of a 36-year-old male with unknown G6PD status who presented with oxidative ha...

Full description

Bibliographic Details
Main Authors: Mohd Tohit, Eusni Rahayu, Nallappan, Geetha, Idris, Faridah, Mustapha, Siti Zubaidah, Abdul Hamid, Hanisah
Format: Article
Language:English
Published: Universiti Putra Malaysia Press 2024
Online Access:http://psasir.upm.edu.my/id/eprint/118344/
http://psasir.upm.edu.my/id/eprint/118344/1/118344.pdf
_version_ 1848867494229442560
author Mohd Tohit, Eusni Rahayu
Nallappan, Geetha
Idris, Faridah
Mustapha, Siti Zubaidah
Abdul Hamid, Hanisah
author_facet Mohd Tohit, Eusni Rahayu
Nallappan, Geetha
Idris, Faridah
Mustapha, Siti Zubaidah
Abdul Hamid, Hanisah
author_sort Mohd Tohit, Eusni Rahayu
building UPM Institutional Repository
collection Online Access
description Methylene blue is an antidote for methaemoglobinaemia, but it is not given to individuals with glucose 6 phosphate dehydrogenase (G6PD) deficiency since it could potentially worsen oxidative haemolysis. We report the case of a 36-year-old male with unknown G6PD status who presented with oxidative haemolysis and methaemoglobinaemia. The fluorescence spot test showed a normal G6PD level. Methylene blue was given, but it was stopped as his anaemia worsened with no improvement in methaemoglobin level. This case highlights the challenges in the management of methaemoglobinaemia with concurrent oxidative haemolysis when the G6PD status of the patient is not known. In the acute presentation of oxidative haemolysis, molecular tests to detect G6PD deficiency can be time consuming and fluorescent spot test could give a false negative result. Therefore, it is highly advisable to avoid methylene blue for patients with unknown G6PD status when they have concurrent oxidative haemolysis and methaemoglobinaemia.
first_indexed 2025-11-15T14:37:23Z
format Article
id upm-118344
institution Universiti Putra Malaysia
institution_category Local University
language English
last_indexed 2025-11-15T14:37:23Z
publishDate 2024
publisher Universiti Putra Malaysia Press
recordtype eprints
repository_type Digital Repository
spelling upm-1183442025-07-08T01:14:34Z http://psasir.upm.edu.my/id/eprint/118344/ Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia Mohd Tohit, Eusni Rahayu Nallappan, Geetha Idris, Faridah Mustapha, Siti Zubaidah Abdul Hamid, Hanisah Methylene blue is an antidote for methaemoglobinaemia, but it is not given to individuals with glucose 6 phosphate dehydrogenase (G6PD) deficiency since it could potentially worsen oxidative haemolysis. We report the case of a 36-year-old male with unknown G6PD status who presented with oxidative haemolysis and methaemoglobinaemia. The fluorescence spot test showed a normal G6PD level. Methylene blue was given, but it was stopped as his anaemia worsened with no improvement in methaemoglobin level. This case highlights the challenges in the management of methaemoglobinaemia with concurrent oxidative haemolysis when the G6PD status of the patient is not known. In the acute presentation of oxidative haemolysis, molecular tests to detect G6PD deficiency can be time consuming and fluorescent spot test could give a false negative result. Therefore, it is highly advisable to avoid methylene blue for patients with unknown G6PD status when they have concurrent oxidative haemolysis and methaemoglobinaemia. Universiti Putra Malaysia Press 2024 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/118344/1/118344.pdf Mohd Tohit, Eusni Rahayu and Nallappan, Geetha and Idris, Faridah and Mustapha, Siti Zubaidah and Abdul Hamid, Hanisah (2024) Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia. Malaysian Journal of Medicine and Health Sciences, 20 (suppl.11). pp. 96-98. ISSN 1675-8544 https://medic.upm.edu.my/upload/dokumen/2024123018320518_MJMHS_0973.pdf 10.47836/mjmhs.20.s11.18
spellingShingle Mohd Tohit, Eusni Rahayu
Nallappan, Geetha
Idris, Faridah
Mustapha, Siti Zubaidah
Abdul Hamid, Hanisah
Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia
title Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia
title_full Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia
title_fullStr Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia
title_full_unstemmed Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia
title_short Importance of glucose 6 phosphate dehydrogenase (G6PD) status in the management of methaemoglobinaemia
title_sort importance of glucose 6 phosphate dehydrogenase (g6pd) status in the management of methaemoglobinaemia
url http://psasir.upm.edu.my/id/eprint/118344/
http://psasir.upm.edu.my/id/eprint/118344/
http://psasir.upm.edu.my/id/eprint/118344/
http://psasir.upm.edu.my/id/eprint/118344/1/118344.pdf