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Last reviewed: 24 Apr 2025
Last updated: 21 Jun 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • jaundice
  • pallor
  • dark urine

Other diagnostic factors

  • nausea
  • cataract
  • splenomegaly

Risk factors

  • male sex
  • neonate
  • ethnic origin in the Mediterranean, sub-Saharan Africa, Middle East, or Southeast Asia
  • family history
  • recent exposure to oxidative drugs
  • infection
  • recent exposure to broad beans (favism)

Diagnostic investigations

1st investigations to order

  • FBC
  • reticulocyte count
  • urinalysis
  • unconjugated (indirect) bilirubin
  • lactate dehydrogenase (LDH)
  • haptoglobin
  • peripheral blood smear

Investigations to consider

  • G6PD fluorescent spot test
  • G6PD spectrophotometry
  • molecular analysis

Emerging tests

  • point of care testing

Treatment algorithm

Contributors

Authors

Atul Bhanu Mehta, MA, MD, FRCP, FRCPath

Professor of Haematology and Consultant Haematologist

Royal Free Hospital and University College London School of Medicine

London

UK

Disclosures

ABM declares that he has no competing interests.

Peer reviewers

Lucio Luzzatto, MD

Professor of Hematology

University of Firenze

Florence

Italy

Disclosures

LL declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

WHO Working Group. Glucose-6-phosphate dehydrogenase deficiency. Bull World Health Organ. 1989;67(6):601-11. Abstract

Cappellini MD, Fiorelli G. Glucose-6-phosphate dehydrogenase deficiency. Lancet. 2008 Jan 5;371(9606):64-74. Abstract

Mason PJ, Bautista JM, Gilsanz F. G6PD deficiency: the genotype-phenotype association. Blood Rev. 2007 Sep;21(5):267-83. Abstract

Roper D, Layton M, Rees D, et al. Laboratory diagnosis of G6PD deficiency. A British Society for Haematology Guideline. Br J Haematol. 2020 Apr;189(1):24-38.Full text  Abstract

Cappellini MD, Fiorelli G. Glucose-6-phosphate dehydrogenase deficiency. Lancet. 2008;371:64-74. Abstract

World Health Organization. Guide to G6PD deficiency rapid diagnostic testing to support P. vivax radical cure. Jul 2018 [internet publication].Full text

Luzzatto L, Nannelli C, Notaro R. Glucose-6-phosphate dehydrogenase deficiency. Hematol Oncol Clin North Am. 2016 Apr;30(2):373-93. Abstract

Reference articles

A full list of sources referenced in this topic is available here.

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