Can Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency play a role in a 28-year-old male with elevated liver enzymes, specifically Alanine Transaminase (ALT) of 99, Aspartate Transaminase (AST) of 38, and Alkaline Phosphatase (Alka Fos) of 119, and alkaline urine pH of 8.5?

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From the Research

G6PD deficiency is unlikely to be the primary cause of this patient's abnormal lab values, as the presentation is more consistent with liver dysfunction. The elevated ALT (99) and mildly elevated AST (38) suggest liver injury, while the alkaline phosphatase of 119 is borderline elevated 1. The high urine pH of 8.5 indicates alkaline urine, which can occur with certain metabolic conditions or urinary tract infections. G6PD deficiency primarily causes hemolytic anemia when triggered by certain medications, foods, or infections, and typically presents with different laboratory abnormalities like decreased hemoglobin, elevated bilirubin, and elevated LDH 2. Some key points to consider in the diagnosis and management of G6PD deficiency include:

  • G6PD deficiency is a common enzyme deficiency that can cause hemolytic anemia, especially in response to certain triggers like fava beans, sulfonamides, or antimalarials 3
  • The diagnosis of G6PD deficiency can be made through enzymatic activity testing or molecular analysis 4
  • Patients with G6PD deficiency should avoid known triggers to prevent hemolytic episodes, and may require additional testing such as a complete blood count and bilirubin levels if hemolysis is suspected 5 To properly evaluate this patient, additional testing would be needed, including a complete blood count, bilirubin levels, and potentially G6PD enzyme activity testing if hemolysis is suspected. If G6PD deficiency is confirmed, the patient should avoid known triggers like certain antibiotics (sulfonamides, nitrofurantoin), antimalarials, fava beans, and naphthalene-containing products to prevent hemolytic episodes 2.

References

Research

Review and drug therapy implications of glucose-6-phosphate dehydrogenase deficiency.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2018

Research

Glucose-6-Phosphate Dehydrogenase Deficiency.

Hematology/oncology clinics of North America, 2016

Research

Diagnosis and management of G6PD deficiency.

American family physician, 2005

Research

G6PD deficiency: An update.

JAAPA : official journal of the American Academy of Physician Assistants, 2019

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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