Acalypha indica -induced transient glucose-6-phosphate dehydrogenase deficiency with acute haemolysis.

Sapol Thepwiwatjit, Nattiya Teawtrakul, Thanachit Krikeerati, Thapanawong Mitsungnern

BMJ case reports 2022 Mar 01

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Acalypha indica is a tropical herb found in Asia. The entire plant, especially the leaves, is used in herbal medicine for several therapeutic purposes. Acute intravascular haemolysis and methaemoglobinaemia have been reported in patients who consume this herb. We present a case of a previously healthy middle-aged man who ingested boiled leaves of A. indica The patient developed clinical symptoms and signs of intravascular haemolysis 7 days after ingestion. Peripheral blood smear showed typical findings of glucose-6-phosphate dehydrogenase (G6PD) deficiency with acute haemolysis. The G6PD activity was low during active haemolysis. The G6PD level, however, returned to normal after 4 months of follow-up. The patient was further tested for common G6PD gene mutations in Southeast Asia and was negative. Ingestion of A. indica may induce transient G6PD deficiency, which in this patient led to acute haemolysis and methaemoglobinaemia. © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Sapol Thepwiwatjit, Nattiya Teawtrakul, Thanachit Krikeerati, Thapanawong Mitsungnern. Acalypha indica -induced transient glucose-6-phosphate dehydrogenase deficiency with acute haemolysis. BMJ case reports. 2022 Mar 01;15(3)