Favism in a 15-month-old baby

摘要

A 15-month-old male baby of Chinese ethnicity was brought by his parents to the emergency department of our hospital with lethargy and yellowish discoloration of eyes, noticed for -24 hours. On examination, the baby was pale and icteric. Blood tests revealed a low hemoglobin of 50 g/L, mild neutrophilia, and normal platelet count. A blood film examination showed normocytic normochromic red cells, hemighosts (blister cells), irregularly contracted cells, and a few bite cells. Indirect bilirubin values were high, and a urine dipstick was positive for hemoglobin. This picture was suggestive of oxidative hemolysis, and the parents stated that the baby was given fava bean soup on the previous day. A glucose 6 phosphate dehydrogenase (G6PD) assay showed a low value (3.2 IU/g Hb; reference range, 8.8-17.5 IU/g Hb), confirming that the baby had hemizygous G6PD deficiency and fava beans had caused hemolytic crisis. There was no family history of favism or neonatal jaundice.