Hyperbilirubinaemia in glucose-6-phosphate dehydrogenase deficient neonates: the role of haemolysis

Abstract

Background: Hyperbilirubinaemia associated with varying complications is a common clinical presentation in Glucose-6- phospate dehydrogenase (G6PD) deficient neonates in our environment. This study is to determine the role of haemolysis in the pathogenesis of hyperbilirubinaemia in G6PD deficient neonates with a view to establishing an appropriate management strategy for acceptable neonatal outcome.
Materials and Methods: One hundred and fifty neonates admitted into the Special Care Baby Units (SCBUs) of the Jos University Teaching Hospital, Bingham University Teaching Hospital, and the Plateau State Specialist Hospital with neonatal jaundice were enrolled for this study between March 2013 and February 2014. The neonates were reviewed clinically and examined for fever, jaundice, cyanosis among other features and they had blood samples collected for laboratory investigations that include Full Blood Count (FBC), Reticulocyte Count, Serum Bilirubin (SB) and G6PD assay.
Results: Median age at presentation was 3 (IQR: 1-4) days. The mean haemoglobin concentration of the study subjects was 15.90 ± 2.23 g/dl while median reticulocyte count was 2.5 (IQR:2-3) %. Total serum bilirubin had a median concentration of 204.00 (IQR:168.25-255.50) μmol/L while median unconjugated bilirubin concentration was 184.50(IQR: 144.50- 233.71) μmol/L. Sixty-one (40.7 %) of the studied neonates were G6PD deficient with mean G6PD activity of 3.99(IQR: 2.72-4.94) IU/gHb
Conclusion: Hyperbilirubinaemia is a common clinical finding in G6PD deficient neonates in our environment but haemolysis is not a major event in its pathogenesis.

Key words: Glucose-6-phosphate dehydrogenase, Haemolysis, Hyperbilirubinaemia, Neonates