Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

A Case Report of Acute Oxidative Haemolysis Following Medicinal Plant Ingestion in a Patient with G6PD Deficiency

Version 1 : Received: 14 January 2024 / Approved: 15 January 2024 / Online: 15 January 2024 (10:33:14 CET)

How to cite: Fernando, N.; Fernando, K.; Williams, S.; Premawardhena, A. A Case Report of Acute Oxidative Haemolysis Following Medicinal Plant Ingestion in a Patient with G6PD Deficiency. Preprints 2024, 2024011116. https://doi.org/10.20944/preprints202401.1116.v1 Fernando, N.; Fernando, K.; Williams, S.; Premawardhena, A. A Case Report of Acute Oxidative Haemolysis Following Medicinal Plant Ingestion in a Patient with G6PD Deficiency. Preprints 2024, 2024011116. https://doi.org/10.20944/preprints202401.1116.v1

Abstract

Introduction Acalypha indica (AI) is an Ayurvedic medicinal plant. Some of this plant’s phytochemicals have been reported to cause oxidative stress in red blood cells. However, we know very little about those chemicals due to a dearth of literature. We present a case in which a patient with a previously unidentified glucose-6-phosphate dehydrogenase (G6PD) deficiency experienced acute hemolysis after ingesting fresh AI plant leaves. Case Presentation A 65-year-old man presented with jaundice, pallor, and haematuria following ingestion of the "Kuppamenia mallum" dish. His peripheral blood picture showed bite cells and Heinz bodies. A positive Brewer's test raised the clinical suspicion of G6PD deficiency. Low values of the G6PD level assessment at the follow-up visit confirmed the diagnosis. Conclusion Although AI is regarded as a medicinal plant, acute hemolysis can also occur after consumption in G6PD-deficient patients. This case emphasises the need for further research to identify the phytochemicals and their concentrations that can induce toxicity.

Keywords

G6PD deficiency; Intravascular hemolysis; Kuppamenia; Acalypha indica; Bite cells; Methemoglobinemia

Subject

Medicine and Pharmacology, Tropical Medicine

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