Figure 1. Hemoglobin trend during admission. PRBC: packed red blood cells.
| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
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Case Report
Volume 15, Number 9, September 2024, pages 231-236
Unexpected Rasburicase-Induced Hemolysis in a Patient With Normal Glucose-6-Phosphate Dehydrogenase Activity
Figures
Table
| Parameter (with units of measure) | Reference range | Before rasburicase administration | 48 h after rasburicase administration |
|---|---|---|---|
| G6PD: glucose-6-phosphate dehydrogenase; APTT: activated partial thromboplastin time; PT: prothrombin time; INR: international normalized ratio; N/A: not available. | |||
| Hemoglobin (Hb) (g/dL) | 11.4 - 15.4 | 8 | 5.3 |
| Hematocrit (%) | 32.8 - 45.6 | 23.9 | 15.7 |
| Bilirubin (mg/dL) | 0.1 - 1.2 | N/A | 7.9 |
| Direct bilirubin (mg/dL) | 0.0 - 0.4 | N/A | 1.35 |
| Haptoglobin (mg/dL) | 30 - 200 | 120 | < 20 |
| Platelets (× 103/µL) | 150 - 450 | 144 | 95 |
| G6PD level (U/g Hb) | 7.0 - 20.5 | N/A | 13 |
| White blood cell count (× 103/µL) | 3.5 - 10 | 24.2 | 17.2 |
| Absolute lymphocyte count (× 103/µL) | 1.16 - 3.18 | 14.76 | N/A |
| Absolute neutrophil count (× 103/µL) | 2.00 - 7.15 | 1.72 | 1.57 |
| Mean corpuscular volume (fL) | 80.0 - 95.0 | 91 | 82.6 |
| Lactate dehydrogenase (U/L) | 120 - 246 | > 5,000 | > 5,000 |
| Reticulocyte count % (absolute count) | 0.5-2.0% | 2.1% (1.2) | 1.9% (0.7) |
| APTT (s) | 23.0 - 31.0 | 25.6 | N/A |
| PT (s) | 9.5 - 11.5 | 12.6 | N/A |
| INR | 0.9 - 1.1 | 1.2 | N/A |
| Fibrinogen (mg/dL) | 180 - 400 | 408 | 390 |
| Uric acid (mmol/L) | 0.15 - 0.37 | 0.91 | < 0.03 |
| Phosphorous (mmol/L) | 0.81 - 1.45 | 1.78 | 1.61 |
| Potassium (mmol/L) | 3.5 - 5.1 | 2.5 | 4.1 |