RT Journal Article
SR Electronic
T1 <em>Acalypha indica</em><strong>-</strong>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.