Although glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder worldwide, it has rarely been reported among Korean. The patient was previously healthy 39 yr old male who showed severe hemolytic anemia and acute renal failure accompanied by hyperbilirubinemia after hepatitis A infection. The additional studies for differential diagnosis of hemolytic anemia showed a moderate deficiency of G6PD enzyme. Because hepatitis A infection in patient with G6PD deficiency present much more severe clinical symptoms, G6PD enzyme should be examined in patients with triggering factors of hemolysis such as hepatitis A infection.
Adult ; Diagnosis, Differential ; Glucosephosphate Dehydrogenase/genetics ; Glucosephosphate Dehydrogenase Deficiency/*complications/diagnosis ; *Hemolysis ; Hepatitis A/*complications/diagnosis ; Hepatitis A Virus, Human/isolation & purification ; Humans ; Hyperbilirubinemia/etiology ; Kidney Failure, Acute/*diagnosis/etiology ; Male

A 23-year-old man presented with abdominal pain after suffering blunt trauma caused by a seatbelt injury. His low platelet count of 137 × 10(9)/L was initially attributed to trauma and his underlying hypersplenism due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Despite conservative management, his platelet count remained persistently reduced even after his haemoglobin and clotting abnormalities were stabilised. After a week, follow-up imaging revealed an incidental finding of a pseudoaneurysm (measuring 9 mm × 8 mm × 10 mm) adjacent to a splenic laceration. The pseudoaneurysm was successfully closed via transcatheter glue embolisation; 20% of the spleen was also embolised. A week later, the platelet count normalised, and the patient was subsequently discharged. This case highlights the pitfalls in the detection of a delayed occurrence of splenic artery pseudoaneurysm after blunt injury via routine delayed phase computed tomography. While splenomegaly in G6PD may be a predisposing factor for injury, a low platelet count should arouse suspicion of internal haemorrhage rather than hypersplenism.
Abdominal Pain ; diagnosis ; etiology ; Accidents, Traffic ; Aneurysm, False ; diagnostic imaging ; etiology ; therapy ; Embolization, Therapeutic ; methods ; Follow-Up Studies ; Glucosephosphate Dehydrogenase Deficiency ; complications ; diagnosis ; Humans ; Injury Severity Score ; Male ; Rare Diseases ; Risk Assessment ; Seat Belts ; adverse effects ; Splenic Artery ; injuries ; Tomography, X-Ray Computed ; methods ; Treatment Outcome ; Wounds, Nonpenetrating ; complications ; diagnosis ; Young Adult