Hemolysis in children with Glucose-6-Phosphate Dehydrogenase deficiency after ingestion of fava beans; facts predicting severity

Objectives: This study aimed to assess the demographic, clinical and biochemical characteristics as predictors of haemolysis after ingesting fava beans. Methods: A cross-sectional study was undertaken. A total of 57 patients with G6PD deficiency were recruited from the Emergency Department of Children Welfare Teaching Hospital, Medical City. Data were collected using a specially designed form. A purposive sampling method was used to recruit 57 patients 49 males and 8 females who were visiting the pediatric emergency department from March to May 2017 with a presentation of acute hemolytic episode of G6PD. Patients were classified into mild or severe haemolysis groups based on their haemoglobin level at the time of admission. Results: Younger age group patients tend to present with the severe form of hemolysis (3.59 years with a P value of 0.001). No significant gender susceptibility between both types of hemolysis. The urban area based living individuals tend to present with mild hemolysis while those from rural areas tends to present with more severe episodes of hemolysis (P value 0.001). There was a significant correlation between the type of fava bean ingestion (fresh or dried) and the severity of hemolysis, those who presented with more severe hemolysis usually had a history of ingestion of fresh type of fava bean. Eight individuals of severe type recorded previous episodes of hemolysis while three individuals of the mild type recorded previous episodes (P value 0.001). Family history of G6PD was significant in 88.2% of individuals with the severe form (P value 0.005). Conclusions: This study is aimed to report several factors that might predict the severity of hemolysis among patients with G6PD deficiency. Younger age, residence in a rural region, ingestion of fresh fava beans, and history of frequent hemolysis incidents are predictors of developing severe hemolysis among children admitted to the emergency room of Children Welfare Teaching Hospital in Medical City/Baghdad.