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. 2025 Mar 7;13(3):e70303.
doi: 10.1002/ccr3.70303. eCollection 2025 Mar.

Unexpected Primaquine-Induced Hemolysis in a G6PD-Normal Patient: A Case Report From Nepal

Aarju Khadka  1 , Sachet Subedi  2 , Nisha Lama  1 , Indu Bhattarai  1 , Chandrashekhar Deuba  1 , Uttam Khatri  1 , Nisha Regmi  1
Affiliations

Unexpected Primaquine-Induced Hemolysis in a G6PD-Normal Patient: A Case Report From Nepal

Aarju Khadka et al. Clin Case Rep. .

Abstract

Primaquine, an antimalarial drug, is essential for preventing relapses of Plasmodium vivax. However, it poses a risk of hemolytic anemia, particularly in glucose-6-phosphate dehydrogenase (G6PD) deficient patients. This case report details a 27-year-old male with normal G6PD levels who developed hemolytic anemia following primaquine therapy for P. vivax malaria. Despite a normal quantitative G6PD analysis, the patient experienced a significant drop in hemoglobin, necessitating early discontinuation of the drug. This case highlights the potential for hemolysis in G6PD-normal patients, underscoring the importance of close monitoring and the limitations of current G6PD screening methods.

Keywords: general medicine; hematology; infectious diseases; toxicology.

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Conflict of interest statement

The authors declare no conflicts of interest.

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