High dose vitamin C induced methemoglobinemia and hemolytic anemia in glucose-6-phosphate dehydrogenase deficiency.
Level 4 - case-series / case-control
Individual clinical case report
PubMed 32561141 · doi:10.1016/j.ajem.2020.05.099
What was done
A case report describing a 75-year-old woman who received a 30 g intravenous vitamin C infusion as unconventional treatment for hemifacial spasm and subsequently presented with acute jaundice, dark urine, and shortness of breath.
What was found
The patient was diagnosed with methemoglobinemia and hemolytic anemia, confirmed via laboratory testing (exact laboratory values were not provided in the abstract). She recovered following supportive care and packed red blood cell transfusion. Glucose-6-phosphate dehydrogenase (G6PD) deficiency was confirmed months after the acute episode.
Why it matters
High-dose intravenous vitamin C can precipitate concurrent hemolytic anemia and methemoglobinemia in patients with G6PD deficiency, even in females and at lower supraphysiological doses (30 g) than previously documented.
Limits
Findings are limited to a single clinical case report with no control comparison. Pre-existing G6PD deficiency was unrecognized prior to treatment, and precise laboratory quantitative parameters are omitted from the abstract.
Cited by
- context Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at risk of hemolysis when given intravenous vitamin C at doses of 40 grams or higher.