Case Report: A Case of Primaquine-Induced Hemoglobinuria in Glucose-6-Phosphate Dehydrogenase Deficient Malaria Patient in Southeastern Bangladesh

Am J Trop Med Hyg. 2020 Jan;102(1):156-158. doi: 10.4269/ajtmh.19-0643.


We herein report the first case of Mediterranean glucose-6-phosphate dehydrogenase (G6PD) variant from Bangladesh. A boy had been admitted to hospital and was diagnosed with uncomplicated Plasmodium vivax infection and treated with 30 mg/kg body weight (BW) chloroquine for 3 days and 4.8 mg/kg BW primaquine (PQ) to be taken over 14 days. The boy was discharged but represented 4 days later with severe hemoglobinuria and fatigue. Hemoglobin was measured at 6.0 g/dL and serum bilirubin was at 5.6 mg/dL, although malaria microscopy was negative. The boy had taken the 4-fold recommended daily dose of PQ and was treated with two fresh blood transfusions. Subsequent molecular analysis showed the boy to have the Mediterranean G6PD variant and a G6PD activity of 0.93 U/gHb.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / adverse effects
  • Antimalarials / therapeutic use
  • Blood Transfusion
  • Child
  • Chloroquine / administration & dosage
  • Chloroquine / therapeutic use*
  • Glucosephosphate Dehydrogenase Deficiency* / genetics
  • Hemoglobinuria / chemically induced*
  • Hemoglobinuria / therapy
  • Humans
  • Malaria / drug therapy*
  • Male
  • Primaquine / adverse effects*
  • Primaquine / therapeutic use*


  • Antimalarials
  • Chloroquine
  • Primaquine