A 43-year-old man of Mediterranean descent presented to his primary care provider for a routine visit. During the examination, the provider noted some mild splenomegaly and tenderness. On closer examination, some scleral icterus was noted. Subsequent labs showed marginally elevated LDH (lactate dehydrogenase), bilirubin, and slight anemia.

G6PD, or glucose-6-phosphate dehydrogenase deficiency, is a genetic condition that makes carriers more susceptible to hemolysis and resultant jaundice. Symptoms usually only appear after a triggering event or intake of a certain food or medication. It is particularly common in people of Mediterranean and African origin and in men more often than in women. The main caution in these patients is to avoid triggers of oxidative stress, which, in extreme cases, can lead to hemolytic anemia, acute renal failure, and death. This patient was questioned regarding recent food intakes or other stressors and was found to have been drinking “several cans of beer” every night. His examination and lab values returned to normal limits, and he abstained from alcohol intake. He was also given information on other foods and medication that he should avoid. (214-5)

Sherril Sego, FNP-C, DNP, is an independent consultant in Kansas City, Mo.

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