Male, 2 years and 7 months.
Pregnancy with controlled insulin-dependent diabetes mellitus
Gestational age 39 weeks, birth weight: 3,015 g, height: 49.5 cm, mother and child with the same blood group O IV (+).
Patient was hospitalized for 8 days in the neonatal period due to hyperbilirubinemia of 25.1 mg/dL without evident cause.
No other morbidities.
It began abruptly with progressive weakness, abdominal pain, fever and vomiting.
Established in the hospital of origin, the objective was to determine the severity of the illness, jaundice and tachycardia (156 x min).
Initial tests revealed anemia: Hematomatophilia (Hto) 18%, hemoglobin (Hb) 5.8 gr/dL GR: 2.0 x million/uL mild to moderate poikilocytosis and polychromatosis.
Leukocytes: 15,200 x mm3, platelets 399,000 x mm3, total bilirubin: 4.9 mg/dL indirect bilirubin: 4.6 mg/dL creatinine, AST: 76.3 IU/L GGT: 25.7 mg/dl
Abdominal ultrasound showed mild hepatomegaly and dilatation of the minimal bile duct.
The patient was referred to a pediatric critical care unit.
On admission, severe anemia, Hto: 15.8% and Hb: 4.7 gr/dL were highlighted, as well as sedimentary diseases, polychromatophilia, moderate erythrocyte sedimentation rate: 17 mm).
Total bilirubin: 4.11 mg/dL, indirect: 3.52 mg/dL.
The rest of laboratory tests showed normal renal and hepatic function, and negative direct Coombs test.
1.
The patient had ingested fresh meat 48 h prior to the onset of symptoms, without taking any drugs.
The diagnosis was hemolytic anemia, probable Favism.
It was managed with intravenous hydration with high volumes, transfused with red blood cells 10 cc/ kg and oral folic acid.
After transfusion, 25% had hematocrit, 8.1 gr/dL, 11.6% had anemia.
At 48 h, the patient remained stable with persistent elevated erythrocytes 14.2%.
Qualitative detection test of G6PD confirmed deficiency of the enzyme.
He had anemia and no signs of hemolysis at one month after onset.
