Effect of Acetaminophen on Glucose-6-Phosphate Dehydrogenase, Mahidol Variant

Pensri Pootrakul, Vicharn Panich, The Thalassemia Center, Faculty of Graduate Studies and Division of Haematology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700 (Thailand) To the Editor, Although acetaminophen (paracetamol) is considered a safe drug for the Mediterranean type of glu-cose-6-phosphate dehydrogenase (G6PD) deficiency [1], a case of moderately severe hemolytic anemia resulting from ingestion of this drug has been recently reported [2]. To confirm the acetaminophen idiosyncrasy in a G6PD-deficient subject we wish to report the effect 1 This study was supported by the US Public Health research grant AM 09805 from the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases. of this drug in G6PD deficiency, Mahidol variant. This is the most common variant in Thai population [3], albeit usually asymptomatic, sometimes presenting an adverse effect after the consumption of certain drugs or chemicals [4]. The experiment was performed in vivo with the subject’s consent, labelling G6PD-deficient Mahidol variant erythrocytes with 51Cr using standard method C (ACD/ascorbic acid method) recommended by ICSH [5]. 10 ml of labelled erythrocytes were then transfused into a ABO-com-patible normal subject. After taking blood samples for 6 consecutive days, a dose of 2 tablets (1,000 mg) of paracetamol was administered orally 3 times a day for a period of 2 weeks during which the blood samples were taken 2-3 times a week for radioactive mea-