G6PD deficiency

  • G6PD deficiency is a genetic disorder in which the body doesn’t have enough of an enzyme (chemical) called glucose-6-phosphate dehydrogenase (G6PD). G6PD is important in protecting red blood cells.  

    The lack of G6PD can lead to red blood cells breaking down too easily (haemolysis) when the person is exposed to certain triggers, which are usually certain foods, viruses or medications. The red blood cells carry oxygen around the body, and the excessive breakdown of red blood cells can lead to anaemia, which can cause pale skin and lethargy. The excessive breakdown of red blood cells may also cause a build up of their waste products, resulting in jaundice (yellow skin/eye discolouration) in some children.

    The condition is more common in males and is usually passed on to male children from their mother, even though she probably had no symptoms herself. G6PD cannot be spread from one person to another.

    There is no cure for G6PD deficiency, and it is a lifelong condition. However, most people with G6PD deficiency have a completely normal life as long as they avoid the triggers. 

    Signs and symptoms of G6PD deficiency

    Your child will only show symptoms of G6PD deficiency when their red blood cells are being broken down in excess. They may have:

    • pale skin (pallor)
    • persistent and/or severe tiredness
    • dark coloured urine (wee)
    • jaundice (yellow skin or eyes).

    It is common for babies to have jaundice in the first week of life, but some babies with G6PD deficiency have jaundice for longer than usual.

    When to see a doctor

    Newborns with persistent jaundice may have a blood test to look for G6PD deficiency. If your child is showing the signs of G6PD deficiency, take them to your GP so that the symptoms can be investigated. 

    If your child has been diagnosed with G6PD deficiency, take them to be checked by a GP whenever any of the following symptoms develop:

    • jaundice (yellow skin and eyes)
    • dark coloured urine
    • anaemia (pale skin and lethargy).

    Care at home

    Make sure people who care for your child (school, kindergarten, child care, babysitters, health professionals) know your child has G6PD deficiency and provide them with a printout of this fact sheet.

    Always check with your doctor or pharmacist before giving any medication to your child.

    To prevent the symptoms of G6PD deficiency, a child with G6PD should avoid the triggers on the following lists:

    Antibiotics

    • Sulphonamides (check with your doctor)
    • Co-trimoxazole (Bactrim, Septrin)
    • Dapsone
    • Chloramphenicol
    • Nitrofurantoin
    • Nalidixic acid

    Antimalarials

    • Chloroquine 
    • Hydroxychloroquine 
    • Primaquine 
    • Quinine
    • Mepacrine 

    Chemicals

    • Moth balls (naphthalene)
    • Methylene blue

    Foods

    • Fava beans (also called broad beans)

    Other drugs

    • Sulphasalazine
    • Methyldopa
    • Large doses of vitamin C
    • Hydralazine
    • Procainamide
    • Quinidine
    • Some anti-cancer drugs

    Some children with G6PD must not take aspirin – check with your doctor first. Always check the labels of any medications you buy without a prescription, and be careful about using herbal, naturopathic or other alternative/complementary therapies.

    Key points to remember

    • G6PD is an inherited condition and cannot be spread from one person to another.
    • Most children with G6PD deficiency have a completely normal life as long as they avoid certain foods and drugs.
    • Some children with the condition will get anaemia or jaundice, especially after taking medicine or eating food they should avoid, or after an infection.  

    For more information

    Common questions our doctors are asked

    How did my child get G6PD deficiency?

    G6PD deficiency is an inherited disease (passed on from previous generations), and cannot be caught by being in contact with someone else. G6PD deficiency is more common in some racial groups, for example, people with African, Asian or Mediterranean heritage. Scientists think there are about 400 million people in the world with G6PD deficiency.

    Should I give my child iron tablets to prevent anaemia?

    Never give a child with G6PD deficiency any medicine (including complementary medicines) or tablets without consulting with your doctor first. You doctor will advise which medications are safe. It is safe for children with G6PD deficiency to take iron, but iron should only be prescribed when the anaemia is confirmed as being due to iron deficiency.

    Can I give my child paracetamol or ibuprofen?

    Yes – paracetamol and NSAIDS (Nonsteroidal anti-inflammatory drugs) are safe for children with G6PD deficiency.  

    What is favism? 

    Favism is when someone has a very severe reaction to fava beans (broad beans). They are at risk of acute haemolysis, in which their red blood cells break down faster than the body can replace them. This can be life-threatening. Some people with favism are even at risk when exposed to pollen from the fava plant. People with favism are always G6PD-deficient, but not all people with G6PD deficiency react this strongly to fava beans.


    Developed by The Royal Children's Hospital General Medicine, Haematology and Pharmacy departments. We acknowledge the input of RCH consumers and carers.

    Reviewed May 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.