RT Journal Article SR Electronic T1 Acalypha indica-induced transient glucose-6-phosphate dehydrogenase deficiency with acute haemolysis JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e245447 DO 10.1136/bcr-2021-245447 VO 15 IS 3 A1 Thepwiwatjit, Sapol A1 Teawtrakul, Nattiya A1 Krikeerati, Thanachit A1 Mitsungnern, Thapanawong YR 2022 UL http://casereports.bmj.com/content/15/3/e245447.abstract 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.