Improved erythrocyte survival with combined vitamin E and selenium therapy in children with glucose-6-phosphate dehydrogenase deficiency and mild chronic hemolysis

Hafez, Muna Mohammed; Amar, El-Sayed; Zedan, M.D. Magdi; Hammad, M.D. Hasan; Sorour, Magdy A; El-Desouky, El-Sayed; Gamil, Nariman M.

doi:10.1016/s0022-3476(86)80833-2

Cited by 32 publications

(24 citation statements)

References 14 publications

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“…The supplemented group received vitamin E supplementation for 60 consecutive days at a dose of 800 IU/day for adult and 400 IU/day for children < 12 years; in a divided dose i,e. 4 times daily 6,19 . Age and sex matched 34 apparently healthy subjects with normal blood G6PD level were taken to observe the baseline data (healthy control) and also for comparison.…”

Section: Methodsmentioning

confidence: 99%

“…Hemolysis of RBC may also occur even without prior administration of drugs in G6PD deficiency [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

“…Supplementation of vitamin E may have an important role in maintaining red cell membrane integrity by reducing osmotic fragility of erythrocyte 10,11 and can minimize the severity of hemolysis in G6PD deficient patients 12 . Again, vitamin E supplementation can restore the required amount of vitamin E level in this group of patients, and thus may prevent hemolysis by improving red blood cells survival 5,6,13 . Normal red blood cell indices like MCV, MCH and MCHC may also be found in peripheral blood film by oral supplementation of vitamin E 11 .…”

Section: Introductionmentioning

confidence: 99%

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Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Sultana¹,

Begum

et al. 2009

Bangabandhu Sheikh Mujib Medical University Journal

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Abstract:Background: Vitamin E has role in maintaining the integrity of red cell membrane by preventing oxidation of polyunsaturated fatty acids and thereby protects cells from oxidative stress-induced lysis in G6PD deficiency, which can be reflected by changes in osmotic fragility of RBC and some absolute values like MCV, MCH & MCHC. Objective: To observe the effects of vitamin E supplementation on fragility of RBC in order to evaluate role of this antioxidant vitamin in reducing chronic hemolysis in G6PD deficient patients. Methods: For this, a total number of 102 subjects with age ranged from 5 to 40 years of both sexes were included in the study. Among them 68 were G6PD enzyme deficient patients, of whom 34 were in supplemented group (study group) and 34 were in non-supplemented group (control group). The supplemented group received vitamin E supplementation for 60 consecutive days at a dose of 800 IU/day for adult and 400 IU/day for children < 12 years (in a divided dose i,e. 4 times daily). Age and sex matched 34 apparently healthy subjects with normal blood G6PD level were taken to observe the base line data (healthy control) and also for comparison. All the G6PD deficient patients were selected from Out Patient Department (OPD) of Hematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2005 to June 2006 and all the healthy subjects were selected from personal contact. Blood G6PD level, osmotic fragility of RBC were measured by standard techniques and MCV, MCH, and MCHC were obtained by calculation. All the parameters were measured on day 1 (one) of their first visit and also were on day 60 in deficient group. Data were compared among the deficient groups, also in supplemented group just before and after supplementation. Analysis of data was done by appropriate statistical method. Results: Mean starting and completing points of osmotic fragility of RBC were significantly higher but MCV, MCH, MCHC were significantly lower in patients suffering from hemolytic anemia due to G6PD deficiency in comparison to those of the healthy control. After supplementation with vitamin E starting and completing points of osmotic fragility of RBC were significantly decreased whereas, MCV, MCH, MCHC were significantly increased towards those of healthy control in supplemented group of patients in comparison to those of their pre-supplemented (day-1) and non-supplemented groups both on day 1 and day 60. Conclusion: From this study it may be concluded that, disturbances of some of the hematological parameter like higher osmotic fragility of RBC and lower MCV, MCH, MCHC occur in G6PD deficient hemolytic anemic patients, which returned towards normal after supplementation of vitamin E, which clearly indicates the role of this anti-oxidant vitamin in maintaining red cell membrane integrity and thereby decreases the rate of hemolysis in this group of patients. So, vitamin E can be supplemented along with other drugs for better management of the patients.

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Section: Methodsmentioning

confidence: 99%

“…Hemolysis of RBC may also occur even without prior administration of drugs in G6PD deficiency [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Sultana¹,

Begum

et al. 2009

Bangabandhu Sheikh Mujib Medical University Journal

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“…Iron and folic acid have shown benefits for hemolysis when caused by low levels of these components but there is no specific research in G6PD deficiency 2 . Vitamin E and selenium seem to have some effect in patients with chronic hemolysis due to antioxidant function and improving effect of red cell half-life 8,9 . Moreover, vitamin E may protect against the reduction of G6PD enzyme activity induced by heavy training 10 .…”

Section: Discussionmentioning

confidence: 99%

“…• Vitamin E and selenium: Seem to have some effect on chronic hemolysis due to antioxidant function and improvement of red cell half-life but there is no specific research in G6PD deficiency 8,9 .…”

Section: Nutritional Managementmentioning

confidence: 99%

A case report of a 4-year-old child with glucose-6-phosphate dehydrogenase deficiency: An evidence based approach to nutritional management

et al. 2017

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Antioxidant effect of EGb 761 on hydrogen peroxide‐induced lipoperoxidation of G‐6‐PD deﬁcient erythrocytes

Sarikcioglu

Öner

Tercan

2004

Phytotherapy Research

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In order to reduce the haemolytic susceptibility of glucose-6-phosphate dehydrogenase (G-6-PD) deficient erythrocytes, Ginkgo biloba extract (EGb 761) and vitamin E (vit E) were used as antioxidant agents and their effects compared. The erythrocyte suspensions from control and G-6-PD deficient patients were subjected to hydrogen peroxide (H2O2) incubation for 1 h. The produced thiobarbituric acid reactive substance (TBARS) levels measured as nmol/g Hb were compared with those of the erythrocytes administered 250 microg/mL EGb 761 or vit E previously or concomitantly with H2O2. Preincubation with EGb 761 reduced the TBARS levels from 317.14 +/- 25.27 to 160.09 +/- 21.97 nmol/g Hb in controls and from 348.24 +/- 7.79 to 205.60 +/- 14.22 nmol/g Hb in deficient erythrocytes. Concomitant application of EGb 761 with H2O2 resulted in similar but less reduction. The antioxidative effects of vitamin E were comparable to those of EGb 761. Contrary to the results obtained from oxidant conditions, the antioxidant characteristics of EGb 761 and vitamin E were not observed when they were applied directly to the erythrocytes without oxidative stress. The findings demonstrate that irrespective of administration time, EGb 761 significantly reduced TBARS levels in the erythrocytes of control and G-6-PD deficient patients subjected to oxidative stress.

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Improved erythrocyte survival with combined vitamin E and selenium therapy in children with glucose-6-phosphate dehydrogenase deficiency and mild chronic hemolysis

Cited by 32 publications

References 14 publications

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

Effects of Oral Supplementation of Vitamin E on Fragility of RBC in Hemolytic Anemic Patients with G6PD Deficiency

A case report of a 4-year-old child with glucose-6-phosphate dehydrogenase deficiency: An evidence based approach to nutritional management

Antioxidant effect of EGb 761 on hydrogen peroxide‐induced lipoperoxidation of G‐6‐PD deﬁcient erythrocytes

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