Post-operative audit of G6PD-Deficient male children with obstructive adenotonsillar enlargement at University College Hospital, Ibadan, Nigeria

Abstract

Background: G6PD deficiency ranks among the commonest hereditary enzyme deficiency worldwide and notable as a predisposing condition to haemolytic crises. The fear of possible untoward effects is often expressed by parents of G6PD deficient male children scheduled for surgery after obtaining an informed and understood consent. The parental perception of obstructive adenotonsillar enlargement in this condition was also appraised.

Methods: A retrospective chart review of all G6PD deficient male children between ages 1 to 7years who had adenotonsillectomy over a 3year period at University college Hospital, Ibadan, Nigeria.

Results: The patients comprised of 22 G6PD deficient male children diagnosed shortly after birth upon development of neonatal jaundice. Fifteen (68.2%) and 6(27.3%) of the patients subsequently developed episodes of drug- induced haemolysis and non-haemolytic drug reactions prior to undergoing adenotonsillectomy by the otolaryngologists. None of the patients was observed to develop haemolytic crises up to 2weeks post-adenotonsillectomy. From the parental perception and responses in the follow-up period, all 22(100%) patient had resolution of noisy breathing, 20(91%) had improvement of snoring and apnoeic spells. Only 15 (68%) were reported to stop mouth-breathing.

Conclusion: The small sample size and lack of assay of serum bilirubin level to determine microscopic haemolysis were reckoned as limitations to the study. The study did not find any case of critical post-anaesthetic or post-operative event. Hence, the benefit derived from the surgeries outweighs the risk of drug-induced hemolysis entertained by both the parents and health-care givers.

Key words: Post-operative audit, Glucose-6-phosphate deficiency, obstructive adenotonsillar enlargement.