PT  - JOURNAL ARTICLE
AU  - Sapol Thepwiwatjit
AU  - Nattiya Teawtrakul
AU  - Thanachit Krikeerati
AU  - Thapanawong Mitsungnern
TI  - <em>Acalypha indica</em><strong>-</strong>induced transient glucose-6-phosphate dehydrogenase deficiency with acute haemolysis
AID  - 10.1136/bcr-2021-245447
DP  - 2022 Mar 01
TA  - BMJ Case Reports
PG  - e245447
VI  - 15
IP  - 3
4099  - http://casereports.bmj.com/content/15/3/e245447.short
4100  - http://casereports.bmj.com/content/15/3/e245447.full
SO  - BMJ Case Reports2022 Mar 01; 15
AB  - Acalypha indica is a tropical herb found in Asia. The entire plant, especially the leaves, is used in herbal medicine for several therapeutic purposes. Acute intravascular haemolysis and methaemoglobinaemia have been reported in patients who consume this herb. We present a case of a previously healthy middle-aged man who ingested boiled leaves of A. indica. The patient developed clinical symptoms and signs of intravascular haemolysis 7 days after ingestion. Peripheral blood smear showed typical findings of glucose-6-phosphate dehydrogenase (G6PD) deficiency with acute haemolysis. The G6PD activity was low during active haemolysis. The G6PD level, however, returned to normal after 4 months of follow-up. The patient was further tested for common G6PD gene mutations in Southeast Asia and was negative. Ingestion of A. indica may induce transient G6PD deficiency, which in this patient led to acute haemolysis and methaemoglobinaemia.