Forty-four patients with Mediterranean-type glucose-6-phosphate dehydrogenase (G-6-PD) deficiency receiving long-term, low-dose aspirin were monitored over three months for evidence of hemolysis. Complete blood count, reticulocyte count and serum bilirubin were normal in all patients before treatment and upon periodic retesting. We conclude that there is sufficient current evidence to remove the hemolytic stigma of aspirin in G-6-PD deficiency, thereby establishing its safety for long-term therapy in this condition.
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References
1.
InselPA. Analgesic-antipyretics and antiinflammatory agents; drugs employed in the treatment of rheumatoid arthritis and gout. In: GilmanAGRallTWNiesASTaylorP, eds. Goodman and Gilman's the pharmacological basis of therapeutics. 8th ed. Elmsford, NY: Pergamon Press, 1990: 638–81.
2.
ReynoldsJEF, ed. Martindale the extra pharmacopoeia. 29th ed. London: The Pharmaceutical Press, 1989: 3–8.
3.
BeutlerE. Glucose-6-phosphate dehydrogenase deficiency. N Engl J Med1991; 324: 169–14.
4.
Glucose-6-phosphate dehydrogenase deficiency and related deficiencies involving the pentose phosphate pathway and glutathione metabolism. In: WintrobeMMLeeGRBoggsDR, eds. Clinical hematology. 8th ed. Philadelphia: Lea & Febiger, 1981: 786–802.
BurkaERWeaverZMarksPA. Clinical spectrum of hemolytic anemia associated with glucose-6-phosphate dehydrogenase deficiency. Ann Intern Med1966; 64: 817–25.
7.
WestringDWPisciottaAV. Anemia, cataracts and seizures in patient with glucose-6-phosphate dehydrogenase deficiency. Arch Intern Med1966; 118: 385–90.
8.
MeloniTForteleoniGOganaAFrancaV. Aspirin-induced acute haemolytic anaemia in glucose-6-phosphate dehydrogenase deficient children with systemic arthritis. Acta Haematol (Basel)1989; 81: 208–9.
9.
OnadekoBOBademosiO. Glucose-6-phosphate dehydrogenase deficiency and intravascular hemolysis. Ir J Med Sci1974; 143: 208–13.
10.
HermanJBen-MeirS. Overt hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency. Isr J Med Sci1975; 11: 340–4.
11.
SzeinbergAKellermannJAdamAShebaCRamotB. Haemolytic jaundice following aspirin administration to a patient with a deficiency of glucose-6-phosphate dehydrogenase in erythrocytes. Acta Haematol (Basel)1960; 23: 58–64.
12.
GladerBE. Evaluation of the hemolytic role of aspirin in glucose-6-phosphate dehydrogenase deficiency. J Pediatr1976; 89: 1027–8.
13.
KellermeyerRWTarlovARBrewerGJCarsonPEAlvingS. Hemolytic effect of therapeutic drugs. Clinical consideration of the primaquine type hemolysis. JAMA1962; 180: 388–94.
14.
WeatherallDJGordon-SmithEC. Haemolytic anaemia. In: WeatherallDJLedinghamJGGWarrellDA, eds. Oxford textbook of medicine. Oxford: University Press, 1987: 19–142.
15.
LuxSE. Hereditary defects in the membrane or metabolism of the red cell. In: WyngaardenJBSmithLH, eds. Cecil textbook of medicine. Philadelphia: WB Saunders, 1988: 909–17.
16.
ShahidiNTWestringDW. Acetylsalicylic acid-induced hemolysis and its metabolism. J Clin Invest1970; 49: 1334–40.
17.
StockmanJALubinBOskiFA. Aspirin-induced hemolysis: The role of concomitant oxidant (H202) challenge. Pediatric Res1978; 12: 927–31.
18.
WorathumrongNGrimesAJ. The effect of o-salicylate upon pentose phosphate pathway activity in normal and G6PD deficient red cells. Br J Haematol1975; 30: 225–31.
