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The hemolytic reaction caused by the ingestion of the standard prophylactic antimalarial dose of primaquine was studied in 3 Caucasian males and 1 Negro male with G-6-PD deficiency. Each Caucasian subject came from an ethnic group in which primaquine sensitivity is uncommon (English, Sicilian, Ashkenazic Jewish). In contrast to the mild hemolytic reaction in the American Negro, destruction of about 20 per cent of circulating red cells occurred in each Caucasian subject. Hemolysis was similar in these individuals despite marked differences in clinical and laboratory studies. One subject had enzymatic studies similar to those observed in G-6-PD deficient Negroes; another had mild but significant hemolysis before the ingestion of primaquine; and the third failed to develop clinical jaundice because of accelerated plasma clearance of bilirubin. These studies suggest that the assay of G-6-PD in hemolysates and even the measurement of pentose phosphate shunt activity in intact red cells do not provide a basis for the prediction of the severity of primaquine sensitivity in vivo.
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Accepted: March 2, 1967
Received: November 1, 1966
☆Supported by the United States Army Medical Research and Development Command, and by Research Grant AM09307 from the National Institute of Arthritis and Metabolic Diseases.
© 1967 Published by Elsevier Inc.