Improvement for Diagnosis of G6PD Deficiency Using an In-House Spectrophotometric Assay
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Creator Duantida Songdej
Title Improvement for Diagnosis of G6PD Deficiency Using an In-House Spectrophotometric Assay
Contributor Usanarat Anurathapan, Nongnuch Sirachainan, Ampaiwan Chuansumrit, Werasak Sasanakul, Pakawan Wongwerawattanakoon, Lalita Mahaklan, Praguywan Kadegasem, Rungrote Natesirinilkul
Publisher Faculty of Medicine Ramathibodi Hospital, Mahidol University
Publication Year 2561
Journal Title Ramathibodi Medical Journal
Journal Vol. 41
Journal No. 2
Page no. 078-089
Keyword G6PD enzyme assay, G6PD assay cut-offs, G6PD deficiency
URL Website https://www.tci-thaijo.org/index.php/ramajournal
Website title Ramathibodi Medical Journal
ISSN 0125-3611
Abstract Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common red cell enzyme defect found in Thai population. Accurate diagnosis is essential for counseling.Objective: To establish a G6PD enzyme assay and reference values.Methods: G6PD deficient Thai individuals and healthy volunteers were recruited. Identification of G6PD mutations and G6PD enzyme assay were performed in all subjects. The cut-offs for classification of residual enzyme level were identified using Receiver Operating Characteristics (ROC) curves.Results: Eighty-eight subjects were divided into three groups according to their G6PD genotype: Group 1, Wild-type (n = 35); Group 2, Carrier (n = 27) and Group 3, Deficiency (n = 26). Median G6PD level (interquartile range) of Group 3 was significantly lower than that of Group 2 and Group 1, 0.6 (0.3 to 1.5) vs 5.3 (4.6 to 6.7) vs 9.3 (8.0 to 10.3) IU/gHb; P < 0.01). G6PD level of < 2.9, > 2.9 - 6.7, and > 6.7 IU/gHb were found to be optimum for classification of residual G6PD enzyme into deficiency, intermediate and normal. These cut-offs resulted in 87% sensitivity and 97% specificity for correct classification of enzyme level according to genetic diagnosis. The enzyme level of 78% of subjects in Group 2 were precisely classified as intermediate deficiency. G6PD Viangchan (871G > A) and Canton (1376G > T) are the two most prevalent mutations found.Conclusions: The established G6PD enzyme assay and its cut-off values provided high sensitivity and specificity for classification of individuals into G6PD deficiency, intermediate and normal.
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