RESUMEN
BACKGROUND: Fava beans (FBs) have long been used as food, and their principal disadvantage is derived from their haemotoxicity. We hypothesized that FB ingestion alters the intestinal gene expression pattern, thereby inducing an immune response. RESULTS: In-depth sequence analysis identified 769 differentially expressed genes (DEGs) associated with the intestine in FB-treated DBA/1 mouse intestines. The identified genes were shown to be associated with biological processes (such as response to stimulus and immune system processes), human disease pathways (such as infectious diseases, endocrine and metabolic diseases, and immune diseases), and organismal system pathways (such as the digestive system, endocrine system, environmental adaptation, and immune system). Moreover, plasma total immunoglobulin E (IgE), histamine, interleukin (IL)-4 and IL-13 levels were significantly increased when the mice were treated with FBs. CONCLUSIONS: These results demonstrated that FBs affect the intestinal immune response and IgE and cytokine secretion in DBA/1 mice.
Asunto(s)
Inmunidad Humoral/inmunología , Mucosa Intestinal/inmunología , Vicia faba/efectos adversos , Animales , Favismo/etiología , Perfilación de la Expresión Génica , Masculino , Ratones , Ratones Endogámicos DBA , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transducción de Señal , Vicia faba/inmunologíaAsunto(s)
Vacunas contra la COVID-19/efectos adversos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Hemólisis , Ictericia/etiología , Neoplasias Pulmonares/tratamiento farmacológico , Vicia faba/efectos adversos , Anciano , Anticuerpos Monoclonales/uso terapéutico , Transfusión Sanguínea , Carcinoma de Pulmón de Células no Pequeñas/sangre , Carcinoma de Pulmón de Células no Pequeñas/complicaciones , Diagnóstico Diferencial , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Humanos , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/complicaciones , Masculino , Vacunación/efectos adversosAsunto(s)
Favismo/etiología , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Glucósidos/efectos adversos , Pirimidinonas/efectos adversos , Vicia faba/efectos adversos , Eritrocitos/metabolismo , Eritrocitos/patología , Favismo/epidemiología , Radicales Libres/metabolismo , Deficiencia de Glucosafosfato Deshidrogenasa/genética , Deficiencia de Glucosafosfato Deshidrogenasa/metabolismo , Glucósidos/metabolismo , Humanos , Vicia faba/químicaRESUMEN
INTRODUCTION: Glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency) is the most common red blood cell (RBC) enzyme disorder. The decrease as well as the absence of the enzyme increase RBC vulnerability to oxidative stress caused by exposure to certain medications or intake of fava beans. Among the most common clinical manifestations of this condition, acute hemolysis, chronic hemolysis, neonatal hyperbilirubinemia, and an asymptomatic form are observed. OBJECTIVE: To analyze the case of a child who presented hemolytic crisis due to favism. CASE REPORT: A 2 year and 7 month old boy with a history of hyperbilirubinemia during the newborn period with no apparent cause, no family history of hemolytic anemia or parental consanguinity. He presented a prolonged neonatal jaundice and severe anemia requiring RBC transfusion. An intake of fava beans 48 h prior to onset of symptoms was reported. G6PD qualitative determination was compatible with this enzyme deficiency. CONCLUSION: G6PD deficiency can be highly variable in its clinical presentation, so it is necessary to keep it in mind during the diagnosis of hemolytic anemia at any age.
Asunto(s)
Favismo/diagnóstico , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Vicia faba/efectos adversos , Preescolar , Deficiencia de Glucosafosfato Deshidrogenasa/fisiopatología , Humanos , Hiperbilirrubinemia Neonatal/patología , MasculinoAsunto(s)
Anemia Hemolítica/prevención & control , Colorantes de Alimentos/efectos adversos , Alimentos/efectos adversos , Deficiencia de Glucosafosfato Deshidrogenasa/dietoterapia , Anemia Hemolítica/etiología , Enfermedades Asintomáticas/terapia , Colorantes de Alimentos/química , Deficiencia de Glucosafosfato Deshidrogenasa/sangre , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Humanos , Mentol/efectos adversos , Naftalenos/química , Polen/efectos adversos , Prunus persica/efectos adversos , Trigonella/efectos adversos , Vicia faba/efectos adversosAsunto(s)
Anemia/etiología , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Hipoxia/etiología , Ictericia/etiología , Dolor Abdominal/etiología , Antioxidantes/farmacología , Antioxidantes/uso terapéutico , Ácido Ascórbico/farmacología , Ácido Ascórbico/uso terapéutico , Preescolar , Tos/etiología , Citocromo-B(5) Reductasa/farmacología , Citocromo-B(5) Reductasa/uso terapéutico , Diagnóstico Diferencial , Servicio de Urgencia en Hospital/organización & administración , Cefalea/etiología , Humanos , Unidades de Cuidados Intensivos/organización & administración , Masculino , Metahemoglobinemia/etiología , Azul de Metileno/farmacología , Azul de Metileno/uso terapéutico , Marruecos/etnología , Terapia por Inhalación de Oxígeno/métodos , Estados Unidos , Vicia faba/efectos adversosAsunto(s)
Anafilaxia/inmunología , Hipersensibilidad a los Alimentos/inmunología , Proteínas de Vegetales Comestibles/efectos adversos , Vicia faba/efectos adversos , Anafilaxia/diagnóstico , Anafilaxia/tratamiento farmacológico , Antialérgicos/uso terapéutico , Biomarcadores/sangre , Preescolar , Culinaria , Epítopos , Hipersensibilidad a los Alimentos/diagnóstico , Hipersensibilidad a los Alimentos/tratamiento farmacológico , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Pruebas Intradérmicas , Masculino , Proteínas de Vegetales Comestibles/inmunología , Pruebas Serológicas , Resultado del Tratamiento , Vicia faba/inmunologíaRESUMEN
AIM: Favism is characterized as acute anemia, due to Glucose-6-phosphate dehydrogenase (G6PD) deficiency as a result of fava beans intake. It is associated with paleness, jaundice, and hemoglobinuria. In this study, signs, symptoms and therapeutic findings of the patients with hemolysis due to G6PD deficiency were investigated in Shahid Madani Hospital of Khorramabad, Lorestan. METHODS: This is a single-center cross-sectional descriptive study that was conducted on all children with G6PD deficiency-induced hemolysis. RESULTS: 308 children (64.3% male and 35.7% female) were included in this study. The most common complaint was jaundice (82.5%) and the most common cause of hemolysis was the intake of fava bean (85.7%). 68% of the children were treated with hydration/fluid therapy. Blood transfusion was conducted in 36.36% of the cases and the mean of blood administered was 18.9 cc/kg. CONCLUSION: In this study, hydration therapy was performed in most of the children presenting favism. Also, the incorrect calculation of the amount of blood needed for transfusion increased the frequency of blood transfusions and prolonged hospitalization time.
Asunto(s)
Favismo/sangre , Favismo/diagnóstico , Deficiencia de Glucosafosfato Deshidrogenasa/sangre , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Vicia faba/efectos adversos , Transfusión Sanguínea/métodos , Niño , Preescolar , Estudios Transversales , Favismo/epidemiología , Favismo/terapia , Femenino , Fluidoterapia/métodos , Deficiencia de Glucosafosfato Deshidrogenasa/epidemiología , Deficiencia de Glucosafosfato Deshidrogenasa/terapia , Humanos , Lactante , MasculinoRESUMEN
INTRODUCTION: Reduced concentrations of glucose-6-phospate dehydrogenase (G6PD) render erythrocytes susceptible to hemolysis under conditions of oxidative stress. In favism, the ingestion of fava beans induces an oxidative stress to erythrocytes, leading to acute hemolysis. DISCUSSION: The simultaneous occurrence of methemoglobinemia has been reported only scarcely, despite the fact that both phenomena are the consequence of a common pathophysiologic mechanism. The presence of methemoglobinemia has important diagnostic and therapeutic consequences. We report a previously healthy boy who presented with combined severe hemolytic anemia and cyanosis due to methemoglobinemia, following the ingestion of fava beans. His condition was complicated by the development of transient acute renal failure. A G6PD-deficiency was diagnosed. We review the literature on the combination of acute hemolysis and methemoglobinemia in favism. Pathophysiologic, diagnostic, and therapeutic aspects of this disorder are discussed.
Asunto(s)
Enfermedad del Almacenamiento de Glucógeno Tipo I/diagnóstico , Enfermedad del Almacenamiento de Glucógeno Tipo I/fisiopatología , Hemólisis , Metahemoglobinemia/complicaciones , Metahemoglobinemia/etiología , Vicia faba/efectos adversos , Lesión Renal Aguda/etiología , Lesión Renal Aguda/fisiopatología , Cianosis/etiología , Cianosis/fisiopatología , Favismo/enzimología , Favismo/genética , Enfermedad del Almacenamiento de Glucógeno Tipo I/terapia , Humanos , Lactante , Masculino , Metahemoglobinemia/fisiopatología , Factores de RiesgoRESUMEN
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency in the world and renders those affected susceptible to potentially severe oxidative hemolysis. Although the resulting hemolysis is most often associated with drug exposure, it has also been reported after consumption of certain foods. With the exception of review articles that reiterated the historical knowledge that fava beans can provoke severe oxidative hemolysis in individuals with G6PD deficiency, very few articles have examined the safety of other food ingredients and food additives for people with G6PD deficiency. Some articles that associated specific foods with hemolysis appeared to be speculative and based on limited information. The objective of this review was to examine the association between foods, including food additives, and the triggering factors of acute hemolysis. The literature was searched for studies and case reports on food consumption and G6PD deficiency. In this review, fava beans were found to be the only food for which there is conclusive clinical evidence linking the risk of hemolytic anemia to individuals with G6PD deficiency. Food additives, at their permitted level of use in North America, can be consumed safely by most patients with G6PD deficiency.
Asunto(s)
Deficiencia de Glucosafosfato Deshidrogenasa/dietoterapia , Animales , Alimentos/efectos adversos , Hemólisis , Humanos , Vicia faba/efectos adversosRESUMEN
BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency worldwide that causes a spectrum of diseases including neonatal hyperbilirubinemia, acute and chronic hemolysis after exposure to oxidative stress. AIM OF THE WORK: This five years retrospective study was carried out to study the demographic, clinical and laboratory data of 1000 patients with G6PD deficiency anemia registered in Hematology Unit, Pediatric Department, Tanta University Hospital. PATIENTS AND METHODS: Data were collected from patient's files, from November 2011 to November 2016, using the pre-designed questionnaires to obtain the complete history, clinical presentation and laboratory investigations including the complete blood count, red blood cells morphology, liver and renal functions and quantitative assay of G6PD enzyme activity by spectrophotometric method. RESULTS: Males were more commonly affected than females (932 males versus 68 females). The highest prevalence of hemolytic crisis in G6PD deficiency patients was found within the age group of 1-3 years (920 patients; 92%) with mean age of the first presentation of 22.8±15.54 months. Patients presented mainly with pallor (1000 patients; 100%), dark red urine (896 patients; 89.6%) and jaundice (878 patients; 87.8%) after 24-72 hours of exposure to the precipitating factors (mean: 36±17.73 hours). Diets were the most common precipitating factor of hemolysis in patients with G6PD deficiency (834 patients; 83.4% of studied cases) especially fava beans (326 patients; 32.6%) and falafel (194 patients; 19.4%) which were the most common precipitating food products causing hemolysis followed by chick pea (108 patients; 10.8%), broad bean (76 patients; 7.6%), green pea (44 patients; 4.4%), pea nuts (38 patients; 3.8%), lentil (28 patients; 2.8%), and lastly black eyed peas (20 patients; 2 %). Infections were the 2nd most common cause of hemolysis (124 patients; 12.4%) including pneumonia (34 patients; 3.4%), tonsillitis (32 patients; 3.2%), typhoid fever (28 patients; 2.8%), hepatitis A (18 patients; 1.8%) and urinary tract infection (12 patients; 1.2%). Drugs were the least common cause of hemolysis (42 patients; 4.2%) including diclofenac sodium (24 patients; 2.4%), ibuprofen (8 patients; 0.8%), acetylsalicylic acid (4 patients; 0.4%), co-trimoxazole (4 patients; 0.4%) and nitrofurantion (2 patients; 0.2%). There was normocytic normochromic anemia with reticulocytosis and Heinz bodies in pre-transfusion complete blood picture in all studied cases. G6PD assay show marked decrease in enzyme level at time of presentation in all cases with the commonest G6PD enzyme level of 3-4 U/gm Hb (592 patients; 59.2%). CONCLUSION AND RECOMMENDATIONS: G6PD deficiency anemia presented mainly with pallor, dark red urine and jaundice after exposure to certain diets, drugs and diseases and therefore patients with G6PD deficiency should avoid exposure to these precipitating factors of hemolysis. We can also recommend large neonatal screening programs to detect cases of G6PD deficiency before the occurrence of acute hemolysis and molecular studies to detect G6PD enzyme variant in Egypt.
Asunto(s)
Anemia Hemolítica/etiología , Enfermedades Transmitidas por los Alimentos/etiología , Deficiencia de Glucosafosfato Deshidrogenasa/fisiopatología , Insuficiencia Hepática/etiología , Insuficiencia Renal/etiología , Adolescente , Adulto , Factores de Edad , Anemia Hemolítica/epidemiología , Anemia Hemolítica/fisiopatología , Niño , Cicer/efectos adversos , Egipto/epidemiología , Salud de la Familia , Femenino , Enfermedades Transmitidas por los Alimentos/epidemiología , Enfermedades Transmitidas por los Alimentos/fisiopatología , Deficiencia de Glucosafosfato Deshidrogenasa/sangre , Insuficiencia Hepática/fisiopatología , Hospitales Universitarios , Humanos , Riñón/fisiopatología , Hígado/fisiopatología , Masculino , Prevalencia , Insuficiencia Renal/fisiopatología , Estudios Retrospectivos , Semillas/efectos adversos , Índice de Severidad de la Enfermedad , Factores Sexuales , Vicia faba/efectos adversosRESUMEN
A three-year-old Syrian boy was hospitalized with symptoms of acute haemolytic anaemia after ingestion of fava beans. He was stabilized by blood transfusion, and genetic examination revealed glucose-6-phosphate dehydrogenase (G6PD) deficiency. Oxidative stress, e.g. ingestion of fava beans, can induce acute haemolytic anaemia in affected individuals. Approximately 400 million people worldwide suffer from G6PD deficiency. The prevalence is high in African, Mediterranean and Middle East countries. Due to increased immigration, we might expect the condition to occur more often in Danish healthcare.
Asunto(s)
Favismo/etiología , Vicia faba/efectos adversos , Preescolar , Dinamarca , Favismo/genética , Favismo/terapia , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Deficiencia de Glucosafosfato Deshidrogenasa/genética , Humanos , Masculino , Siria/etnologíaAsunto(s)
Favismo/inducido químicamente , Levodopa/uso terapéutico , Enfermedad de Parkinson/tratamiento farmacológico , Fitoterapia/efectos adversos , Vicia faba/efectos adversos , Favismo/etnología , Favismo/genética , Humanos , Judíos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/etnologíaAsunto(s)
Cucurbita , Ingestión de Alimentos , Favismo/genética , Deficiencia de Glucosafosfato Deshidrogenasa/genética , Glucosafosfato Deshidrogenasa/genética , Vicia faba/efectos adversos , Favismo/etiología , Contaminación de Alimentos , Humanos , Lactante , Masculino , Polimorfismo de Nucleótido SimpleRESUMEN
A 8 month-old infant presented with acute onset of severe jaundice, anemia requiring transfusion and Glucose-6-Phosphate Dehydrogenase deficiency. The infant did not take drugs, he did not consume fava beans, but fava beans DNA was found on pumpkin he consumed the day before jaundice onset. This is the first case of hemolysis triggered by ingestion of food cross-contaminated with fava beans.
Asunto(s)
Favismo/diagnóstico , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Vicia faba/efectos adversos , Cucurbita/efectos adversos , Contaminación de Alimentos , Humanos , Lactante , Ictericia/etiología , MasculinoRESUMEN
BACKGROUND: Fava beans (FBs) have long been used as food, and their principal disadvantage is derived from their haemotoxicity. We hypothesized that FB ingestion alters the intestinal gene expression pattern, thereby inducing an immune response. RESULTS: In-depth sequence analysis identified 769 differentially expressed genes (DEGs) associated with the intestine in FB-treated DBA/1 mouse intestines. The identified genes were shown to be associated with biological processes (such as response to stimulus and immune system processes), human disease pathways (such as infectious diseases, endocrine and metabolic diseases, and immune diseases), and organismal system pathways (such as the digestive system, endocrine system, environmental adaptation, and immune system). Moreover, plasma total immunoglobulin E (IgE), histamine, interleukin (IL)-4 and IL-13 levels were significantly increased when the mice were treated with FBs. CONCLUSIONS: These results demonstrated that FBs affect the intestinal immune response and IgE and cytokine secretion in DBA/1 mice.
Asunto(s)
Animales , Masculino , Ratones , Vicia faba/efectos adversos , Inmunidad Humoral/inmunología , Mucosa Intestinal/inmunología , Transducción de Señal , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Perfilación de la Expresión Génica , Vicia faba/inmunología , Favismo/etiología , Ratones Endogámicos DBARESUMEN
BACKGROUND AND OBJECTIVES: The etiology of favism remains unclear and the fate of favic patients has not previously been studied. Therefore, individuals who had experienced an episode of favism were studied regarding subsequent fava bean ingestion, including the reason for fava bean ingestion after the initial favic attack and any adverse reactions. In addition, a new hypothesis for the etiology of favism is proposed. PATIENTS AND METHODS: From June 2005 to June 2012, a total of 38 patients with a history of favism were included in this study. Circumstances regarding the initial favic attack were obtained from medical records and patient interviews, and subsequent fava bean ingestion and recurrence of symptoms were investigated. RESULTS: Three of the 38 patients (7.9%) were female, and 35 (92.1%) were male. The mean age was 27.9 years (14-63 years). The first attack of favism occurred before 10 years of age for 31 patients (81.6%) and in the springtime for 35 patients (92.1%). Thirty-three patients (86.7%) regularly ate fava beans before the attack, and 35 (92.1%) resumed eating fava beans within 1-17 years after the attack without symptoms. Two patients (5.2%) experienced a single recurrence of symptoms. No evidence of hemolysis was found in the four patients checked after fava bean re-ingestion. CONCLUSIONS: Patients resumed eating fava bean for various reasons, and the recurrence of symptoms was uncommon. An infectious agent such as a virus may play a role in the development of favism.