Glucose-6-phosphate dehydrogenase deficiency in two returning Operation Iraqi Freedom soldiers who developed hemolytic anemia while receiving primaquine prophylaxis for malaria

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...

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Bibliographic Details
Published in:Military medicine 2005-04, Vol.170 (4), p.273-276
Main Authors: Carr, Jr, Marcus E, Fandre, Matthew N, Oduwa, Felix O
Format: Article
Language:English
Subjects:
Abdomen
Adult
Analgesics
Anemia
Anemia, Hemolytic - chemically induced
Antimalarials - adverse effects
Antiparasitic agents
Comorbidity
Dehydrogenases
Disease prevention
Emergency medical care
Fever
Glucose
Glucosephosphate Dehydrogenase Deficiency - complications
Glucosephosphate Dehydrogenase Deficiency - epidemiology
Headaches
Hemoglobin
Hemolysis - drug effects
Humans
Laboratories
Malaria
Malaria - drug therapy
Malaria - epidemiology
Male
Military Personnel
Nausea
Patients
Primaquine - adverse effects
Proteins
Risk Factors
Urine
Vomiting
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Summary: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.
ISSN:0026-4075
1930-613X
DOI:10.7205/MILMED.170.4.273