Counselling on

g6pd deficiency
Situation

Baby Shamira Turks born on April 10, 2019 from a 36 y/o, G3P2
mother in your facility. Two days after delivery, patient was discharged
from your facility, well and with good suck. Now, Baby Shamira is 1
month old and the result of Newborn Screening test was relayed to you
by the Newborn Screening Center-NIH with a positive screening for
G6PD Deficiency.
1. What is the initial step that you will do?

NSC Lab Informs Follow up Nurse

Follow up Nurse Informs NBS HP/AP/ROD by

phone within 24 hours

HP/AP/ROD informs parents of newborn with

positive screen for confirmatory
tests/referral/management
2. What will you tell the parents about the
result of Newborn Screening?

• G6PD Deficiency, an inherited disorder which makes red blood

cells more prone to hemolysis and may manifest as anemia, jaundice or
dark colored urine.

• Emphasize that this is only a screening test and confirmatory

testing should be performed
 How it is acquired?

X-Linked
Inheritance
which makes G6PD
Deficiency more
common to boys
than girls
Male
Female
3. What is the option for the confirmatory testing?
Test Done in Confirmatory Center
-PARENTS GO TO CONFIRMATORY
CENTER IN NCR OR BATANGAS
-Medical City
-Our Lady of Lourdes Hospital
-MCU-DTMF
-Batangas Regional Hospital
Parents pay for their transportation,
testing fee
OPTION 1
Blood Collection and Send Out of Sample
-PARENTS GO TO BLOOD EXTRACTION
UNITS
-Blood sample is collected , labeled
and packed
-Parents pay for their transportation,
materials needed, courier fee and
testing fee
OPTION 2
4. If parents submits the child for confirmatory
testing, what will you advise them regarding
exposure the triggers while waiting for the result?
• Do counselling on the foods, chemical and drugs that needs to
be avoided
• If baby is sick, inform doctors that baby has g6pd deficiency
• Provide g6pd deficiency brochure
5. What will you advise the parents if they already
have the result of the confirmatory testing?

• Follow up with the attending physician for the diagnosis of the

disorder and management
• Do counselling on the foods, chemical and drugs that needs to be
avoided
• If baby is sick, inform doctors that baby has g6pd deficiency
• Provide g6pd deficiency brochure
6. If the result of the is enzyme below the normal
value, what will the advise on the triggers which
can cause hemolysis?
• Treatment for G6pd deficiency is preventive and supportive
• counsel on foods, drugs, and chemical to avoid which can
trigger hemolysis
• refer to g6pd deficiency brochure
 Important Reminders for G6PD Deficient Individuals
(Mga mahahalagang paalala para sa taong may G6PD deficiency)

1. If you have coughs, colds or other bacterial or viral infections,

make sure to inform your doctor that you have G6PD deficiency.
(Kung mayroon kang ubo’t sipon o iba pang sakit, huwag
kalimutang sabihin sa doktor na mayroon kang G6PD deficiency.)
2. If you have ingested or were exposed to any medication and
your urine became tea-colored, inform your doctor immediately.
(Kung may nainom kang gamot at ang ihi mo ay naging kulay tsaa,
tumawag kaagad sa doktor.)
 Important Reminders for G6PD Deficient Individuals
(Mga mahahalagang paalala para sa taong may G6PD deficiency)

3. If you notice yellowish discoloration of your skin, sclera or any

part of your body, consult your doctor immediately.
(Kung napansin mong naninilaw ang iyong balat, mata or
alinmang bahagi ng iyong katawan, kumunsulta kaagad sa
doktor.)

4. Avoid ingestion of or exposure to the following drugs and

chemicals:
(Iwasan ang mga sumusunod na gamot at kemikal)
 Signs and symptoms of complications of exposure
to food and drugs with oxidative components

(Senyales at sintomas ng komplikasyon dulot ng hindi pag-iwas

sa mga ipinagbabawal na gamot at pagkain

1. Hemolytic anemia (pamumutla dahil sa pagkasira ng red blood cells)

2. Jaundice (paninilaw)

3. Signs of inadequate oxygen transport (pagkahilo, hirap sa paghinga,panghihina at

pagkabalisa)

4. Headache and pain in the abdomen, back or both (pananakit ng ulo, tiyan o likod)
Signs and symptoms of complications of exposure
to food and drugs with oxidative components
(Senyales at sintomas ng komplikasyon dulot ng hindi pag-iwas sa mga
ipinagbabawal na gamot at pagkain

5. Palpitation (mabilis na pintig ng puso)

6. Seizure (kombulsyon)

7. Hepatomegaly (paninigas ng kanang bahagi ng

tiyan dahil sa paglaki ng atay)
Shamira Turks OPD
4/13/2019 0Y1M3D
4/16/2019 Female
--- ---
--- 4/10/2019

Result of G6PD
10

Confirmatory Test for

Sharmila Turks
 Classes of G6PD Enzyme Variants

Level of
Class Deficiency Enzyme Activity Results Range Sharmila Turks Result
1 months old - 10.00 U/gHb
Depending on the Normal Range
Chronic Non-Spherocytic
I Severe
Hemolytic Anemia
of the Confirmatory Center and
Age of Patient
Example:
Depending on the Normal Range For Our Lady of Lourdes Hospital
Less than 10% of Normal
II Severe
(1.477)
of the Confirmatory Center and G6PD Deficiency Confirmatory Center,
Age of Patient normal values are as follows:

10-60% of Normal Depending on the Normal Range Newborn - >16.22 U/gHb

III Moderate
(1.477 -8.862) of the Confirmatory Center and 1-6 months old - >14.77 U/gHb
Age of Patient Above 6 mos old - >13.01 U/gHb

Depending on the Normal Range

Mild to 60-150% of Normal
IV None (8.86 – 22.15)
of the Confirmatory Center and
Age of Patient
Greater than 150% of Depending on the Normal Range
V None Normal of the Confirmatory Center and
(22.15 and above) Age of Patient