Drug which may lead to hemolysis in a child with G6PD deficiency is –
**Core Concept**
G6PD deficiency is a genetic disorder characterized by a deficiency of the enzyme glucose-6-phosphate dehydrogenase, which is essential for protecting red blood cells from oxidative damage. Individuals with G6PD deficiency are susceptible to hemolysis (red blood cell destruction) due to exposure to certain medications, foods, or infections.
**Why the Correct Answer is Right**
Certain medications can trigger hemolysis in individuals with G6PD deficiency by generating reactive oxygen species (ROS) that overwhelm the limited antioxidant defenses. One such medication is primaquine, a antimalarial drug that is metabolized to a compound that can cause oxidative stress. This leads to the formation of methemoglobin, which can precipitate hemolysis in susceptible individuals. The enzyme G6PD plays a crucial role in maintaining the integrity of red blood cells by reducing glutathione, a key antioxidant, and protecting against oxidative damage.
**Why Each Wrong Option is Incorrect**
**Option A:** The other options are not directly associated with oxidative stress or hemolysis in G6PD deficiency. While some medications may have adverse effects in G6PD deficiency, they are not as directly implicated as primaquine.
**Clinical Pearl / High-Yield Fact**
Primaquine and other oxidant medications should be used with caution in individuals with G6PD deficiency, and patients should be screened for this enzyme deficiency before initiating these medications. A simple screening test can detect G6PD deficiency, and alternative medications can be prescribed to minimize the risk of hemolysis.
**Correct Answer: C. Primaquine**