Automated-red cell exchange for methaemoglobinaemia in a G6PD-deficient patient.

Methaemoglobinaemia in G6PD deficiency can be managed by oxidizing agents such as methylene blue and red cell exchange (RCE). We describe a G6PD-deficient patient who presented with oxidative stress with methaemoglobinaemia and was successfully managed with automated-RCE. At presentation, the patient had anaemia, was restless, was tired and had dyspnoea. Co-oximetry showed methaemoglo-binaemia of 10.1 U/g. Further testing revealed the patient had insufficient quantities of G6PD enzyme activity (0.1 U/g Hb). In view of methaemoglobinaemia, severe G6PD deficiency and signs of haemolysis, therapeutic RCE was planned. The patient underwent two automated-RCE procedures on consecutive days, bringing down his methaemoglobin levels from 12.5 to 0.1 U/g. In each procedure, 1.5 volumes of RCE at 100% balance rate was performed using 5 units of red blood cells. The patient responded well to RCE and other supportive treatment and was off medication and doing well at day 100 of follow-up.

Allergy and inflammation: an immunological and therapeutic approach.

All organisms are protected by their immune system but occasionally this system overreacts leading to allergic and inflammatory reactions in the body. These reactions are the starting points of various diseases like asthma, eczema and urticaria etc. They involve activation of T cells, release of histamines, toxic chemicals from mast cells and eosinophils respectively. Several chemically and naturally synthesized therapeutic agents are available for the treatment of these immunological diseases. The present review provides a detailed account of mechanism of allergic and inflammatory reactions, its types and various treatment strategies with a special focus on some recent patents in this field.