Glucose-6-Phosphate Dehydrogenase Deficiency in Two Returning Operation Iraqi Freedom Soldiers Who Developed Hemolytic Anemia While Receiving Primaquine Prophylaxis for Malaria
Authors: Carr, Marcus E.1; Fandre, Matthew N.2; Oduwa, Felix O.2
Source: Military Medicine, Volume 170, Number 4, April 2005 , pp. 273-276(4)
Publisher: AMSUS - Association of Military Surgeons of the U.S.
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Abstract:
Use of antimalarial prophylaxis continues to be routine practice among military personnel returning from areas where malaria is endemic. Primaquine may be used for terminal prophylaxis against Plasmodium ovale and Plasmodium vivax. Serious complications of this regimen are infrequent. We report the occurrence of significant hemolytic anemia for two soldiers returning from Operation Iraqi Freedom. They presented with dark urine, headaches, and classic laboratory findings of hemolysis. Both soldiers were subsequently found to have glucose-6-phosphate dehydrogenase deficiency, and both responded to conservative treatment and cessation of medication. Although this complication is unusual, medical personnel involved in the care of recently returned deployed service members should be alert to its potential occurrence among patients who are receiving antimalarial prophylaxis. This complication could be completely avoided with prescreening of personnel for glucose-6-phosphate dehydrogenase deficiency, as is currently done in the Air Force and Navy, before the use of primaquine.Document Type: Research article
Affiliations: 1: Department of Internal Medicine, Darnall Army Community Hospital, Fort Hood, TX 26544-4752; and Departments of Internal Medicine and Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298-0230. 2: Department of Family Practice, Darnall Army Community Hospital, Fort Hood, TX 26544-4752.
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