Combination of Methaemoglobinaemia and G6PD Deficiency with Potential Paradoxical Intravascular Haemolysis

Glucose 6 Phosphate Dehydrogenase (G6PD) deficiency is endemic in some countries including some parts of India. Because G6PD provides the reducing energy to cells by maintaining level of reduced nicotinamide adenine dinucleotide phosphate (NADPH) within the cells, deficiency of G6PD is associated with haemolysis. Also there is higher risk of development of acquired methaemoglobinaemia in such population if exposed to certain medicines. Treatment of methaemoglobinaemia in such circumstances is associated with worsening of intravascular haemolysis.