Melik DEMİR, Ömer Ferudun AKKUŞ, Gökay TAYLAN

GLUKOZ 6 FOSFAT DEHİDROGENAZ ENZİM EKSİKLİĞİ OLAN HASTADA PERKÜTAN KORONER GİRİŞİM SIRASINDA YAYGIN TROMBOZ

Pentoz monofosfat yolu aracılığı ile glukoz-6-fosfat dehidrogenaz (G6PD) enzimi eritrositleri ve hemoglobin moleküllerini oksidatif strese karşı korur. Dünyadaki en sık enzim eksikliği olarak görülen G6PD enzim eksikliğinde; akut hemolitik anemi, yenidoğan sarılığı, favizm ve kalısal sferositik olmayan hemolitik anemi gibi klinik durumlar görülür. Akut koroner sendrom esnasında genel klinik duruma bağlı oluşan oksidatif ajanlar ve koroner anjiyografi öncesi ve sırasında uygulanan medikasyonlar hemolitik ve trombotik krize neden olabilirler. Bu yazıda G6PD eksikliği bulunan 64 yaşındaki kadın hastaya akut koroner sendrom ön tanısı ile koroner anjiyografi uygulanan ve perkütan koroner girişim sırasında ve takibinde gelişen yaygın koroner tromboz vakasını sunduk.

Anahtar Kelimeler:

Akut koroner sendrom, akut tromboz, glukoz-6-fosfat dehidrojenaz, perkütan koroner girişim.

DIFFUSE THROMBOSIS DURING PERCUTANEOUS CORONARY INTERVENTION IN A PATIENT WITH GLUCOSE 6 PHOSPHATE DEHYDROGENASE ENZYME DEFICIENCY

Through the pentose monophosphate pathway, glucose-6-phosphate dehydrogenase (G6PD) enzyme protects erythrocytes and hemoglobin molecules against oxidative stress. In G6PD enzyme deficiency, which is seen as the most common enzyme deficiency in the world; clinical conditions such as acute hemolytic anemia, neonatal jaundice, favism and inherited non-spherocytic hemolytic anemia are observed. During acute coronary syndrome, oxidative agents and medications applied before and coronary angiography may cause hemolytic and thrombotic crisis. In this article, we performed coronary angiography on a 64-year-old female patient with G6PD deficiency with a pre-diagnosis of acute coronary syndrome. We present a widespread case of coronary thrombosis during and after percutaneous coronary intervention (PCI).

Keywords:

Acute coronary syndrome, acute thrombosis, glucose-6- phosphate dehydrogenase, percutaneous coronary intervention.,

PDF

___

Pes GM, Parodi G, Dore MP. Glucose-6-phosphate dehydrogenase deficiency and risk of cardiovascular disease: A propensity score-matched study. Atherosclerosis 2019;282:148-53.
Cappellini MD, Fiorelli G. Glucose-6-phosphate dehydrogenase deficiency. Lancet 2008;371:64-74.
Frank JE. Diagnosis and management of G6PD deficiency. Am fam phy. 2005;72:1277-82.
Bienzle U, Ayeni O, Lucas AO, Luzzatto L. Glucose-6-phosphate dehydrogenase and malaria. Greater resistance of females heterozygous for enzyme deficiency and of males with non-deficient variant. Lancet 1972;1:107-10.
Dore MP, Portoghese M, & Pes GM. The Elderly with Glucose-6-Phosphate Dehydrogenase Deficiency are More Susceptible to Cardiovascular Disease. J Atheroscler Thromb. 2021;28:604-10.
Stockman JA, Lubin B & Oski FA. Aspirin-induced hemolysis: the role of concomitant oxidant (H2O2) challenge. Pediatr Res. 1978;12:927-31.
Li J, Chen Y, Ou Z, et al. Aspirin Therapy in Cardiovascular Disease with Glucose-6-Phosphate Dehydrogenase Deficiency, Safe or Not?. Am J Cardiovasc Drugs. 2021;21:377-82.