Glucose 6 Phosphate

Glucose-6-Phosphate

Background: Glucose-6-Phosphate dehydrogenase (G-6-PD) deficiency is commonly associated with severe neonatal jaundice, which can result in kernicterus. Healthy Greek newborns were tested to determine the current burden of G-6-PD deficiency-associated severer jaundice. In post, the efficacy of the preventive use of Sn-mesoporphyrin (SnMP), a potent inhibitor of heme oxygenase activity and bilirubin production, in relieving jaundice in neonates with G-6-PD deficiency was assessed.

Method and Findings: The participants were 172 G-6-PD-deficient newborns (group A), 168 G-6-PD-normal newborns (group B), and 58 G-6-PD-deficient newborns enrolled earlier (group C). Group A received SnMP treatment at a mean ago of 26.7 hours. Incremental plasma bilirubin concentration (PBC) changes from cord blood at 24 hours of age were similar among the 3 groups.  At 24 to 48 hours, however, differences were significant, mean being 0.63 mg/dl in group A, 1.69 mg/dl in group B, and 2.45 mg/dl in group C. Age at which PBC peaked also differed significantly among groups. These differences occurred despite the use of phototherapy in 15% of group B and 31% of group C newborns. None of those treated with SnMP needed phototherapy.

Conclusions: Compared with normal newborns, G-6-PD-deficient newborns had 2 fold increase in the prevalence of significant hyperbilirubinemia requiring phototherapy. One SnMP dose given on the first day of life shifted the peak PBC distribution to lower values in the deficient infants, entirely eliminating the need for phototherapy.