Glucose-6-phosphate dehydrogenase

Answer 1

Definition

Glucose-6-phosphate dehydrogenase (G6PD) is a type of protein, called an enzyme, that helps red blood cells work properly. The G6PD test looks at the amount (activity) of this substance in a patient's red blood cells.

Alternative Names

RBC G6PD test; G6PD screen

How the test is performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

How to prepare for the test

No special preparation is usually necessary.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

Your doctor may order this test if you have signs of G6PD deficiency. This means you do not have enough G6PD activity.

Too little G6PD activity leads to the destruction of red blood cells. This process is called hemolysis. When this process is actively occurring, it is called a hemolytic episode.

Hemolytic episodes can be triggered by infections, severe stress, certain foods (such as fava beans), and certain drugs, including:

• Antipyretics (drugs used to reduce fever)
• Nitrofurantoin
• Phenacetin
• Primaquine
• Sulfonamides
• Thiazide diuretics
• Tolbutamide
• Quinidine

If this test is done during a hemolytic episode it may be falsely positive and misleading. This is because the cells most likely to have low G6PD levels (older cells) have been destroyed, and those remaining may show normal G6PD levels.

After recovery from the episode, older cells will show lower levels of G6PD, resulting in a positive test.

Normal Values

Normal values vary and depend upon the laboratory used. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Abnormal results mean you have a G6PD deficiency, which can cause hemolytic anemia in certain conditions.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

Scwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 164.

Yee DL, Bollard CM, Geaghan SM. Appendix: Normal Blood Values: Selected Reference Values for Neonatal, Pediatric, And Adult Populations. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 164.

Answer 2

Definition

Glucose-6-phosphate dehydrogenase (G6PD) is a type of protein, called an enzyme, that helps red blood cells work properly. The G6PD test looks at the amount (activity) of this substance in a patient's red blood cells.

Alternative Names

RBC G6PD test; G6PD screen

How the test is performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

How to prepare for the test

No special preparation is usually necessary.

How the test will feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

Your doctor may order this test if you have signs of G6PD deficiency. This means you do not have enough G6PD activity.

Too little G6PD activity leads to the destruction of red blood cells. This process is called hemolysis. When this process is actively occurring, it is called a hemolytic episode.

Hemolytic episodes can be triggered by infections, severe stress, certain foods (such as fava beans), and certain drugs, including:

• Antipyretics (drugs used to reduce fever)
• Nitrofurantoin
• Phenacetin
• Primaquine
• Sulfonamides
• Thiazide diuretics
• Tolbutamide
• Quinidine

If this test is done during a hemolytic episode it may be falsely positive and misleading. This is because the cells most likely to have low G6PD levels (older cells) have been destroyed, and those remaining may show normal G6PD levels.

After recovery from the episode, older cells will show lower levels of G6PD, resulting in a positive test.

Normal Values

Normal values vary and depend upon the laboratory used. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Abnormal results mean you have a G6PD deficiency, which can cause hemolytic anemia in certain conditions.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 164.

Yee DL, Bollard CM, Geaghan SM. Appendix: normal blood values: selected reference values for neonatal, pediatric, and adult populations. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 164.

Reviewed By

Review Date: 03/21/2010

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.