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Plasma magnesium during hemolytic crisis in children with favism
360
BRIEF NOTES
Plasma magnesium during hemolytic crisis in children with favism In a previous investigation, we noted a marked increase of serum magnesium during the hemolytic crisis in a few cases of favism I. Similar findings were also later reported by Ferlazzo et al.*. In the present paper, we report a study on plasma magnesium levels in 12 children with acute hemolytic anemia due to favism. MATERIALS AND METHODS
Twelve children (IO males, 2 females) were investigated, their ages ranging between I8 months and 8 years. At the time of admission, they all presented clear clinical signs of massive hemolysis {severe anemia, mild jaundice, hemoglobinuria), a history of previous ingestion of Vicia faba seeds, and were found to be enzymopenic (homozygotes or hemizygotes Gd (--) Med) in erythrocyte glucose-6-phosphate dehydrogenase. All cases were treated with blood transfusions during their hospital stay. Blood for the analysis was collected (in heparin): I. at time of admission to the hospital; 2. immediately after blood transfusion; 3. at 24, 48, 72 hours and 7 days after transfusion. Plasma magnesium was assayed by the titan yellow method according to Masson a. This technique has given satisfactory results in our laboratory, and the values obtained in normal subjectst, 4 are similar to those obtained with methods described more recently. RESULTS AND COMMENT Values of plasma magnesium at the various times are reported in Table I. Prior to transfusion, the plasma magnesium level was considerably higher than in normal children of comparable age. Immediately after transfusion, there was a significant decrease in Mg levels (P < o.oi); 24 h later, plasma magnesium decreased further (P < o.oi), and after 48 h it attained values which were comparable to those recorded in healthy children. "FABLE 1 PLASMA MAGNESIUM L E V E L S R E C O R D E D AT D I F F E R E N T T I M E S
No. of cases Mean values S.o. .
.
.
.
.
.
.
.
.
.
.
.
.
.
Before trans,
After trans.
After 24 h
After 48 h
After 7~ h
After 7 days
12
I2
I2
I2
8
I2
2.37 o.24 .
.
.
.
.
.
.
.
.
.
.
.
.
(mequiv/l)
.
.
.
2.2t o.27
2.ol o.28
1.8t o.x5
1.79 o.li
t.77
o.I3
. ...........
The increased level of plasma Mg might be due to tile massive breakdown of red cells, and possibly to its decreased renal excretion. The decrease of magnesiemia following transfusion can be explained by the dilution effected by transfused blood which shows an Mg level lower than normal (due, in turn, to dilution of donor's blood with ACD solution). A similar, though much more striking, decrease was Clin. CMm. Acta, 27 (i97o) 36¢-36I
36t
BRIEF NOTES
recorded by us during exchange transfusion with ACD blood s in newborn babies with hyperbilirubinemia. In our casc~, no electrocardiograms were taken" we never detected any signs of central nervous system depression, and for every patient the clinical course was favorable and uneventful.
Institute of Genetics of the Faculty of Science (Center .for Evolutionary Genetics of National Research Council) and Pediatric Clinic of Rome University (Italy)
G. F. SPENNATI L. BUSI~CO L. CO,CA E. BOTTt,~I
REFERENCES t E. BOTTINI, Boll. Soc. ltal. Biol. Sper., 36 (s96o) 91x. z A. FERt.AZZO, G. LOMBARDO, G. ARENA AND J. GUARNIERE, /i~aS$. Clin. Terap. Sci. Al~ini, 64 (x965) 69. 3 M. MASSON, Rev. Franf. l~tudes Clin. Biol., z (t957) 413. 4 L. Busx~co, G. F. SPENNATX AND L. SARTORI, Jlcta Paed. Latina, 21 (t968) 242. 5 E. BOTTINI, G. VENTURA0 G. COCCIANTE AND E. DE LUCA CARAPE~LA, Biol. 2Veonatorum, 12 (1968) Io2. Reprint address: E. Bottini, Ciinica Pediatrica dell'UniversitY, Roma, Italy.
Received September xS, x969 Clin. Chim, Acla, 27 (x97 o) 36o-36i
BRIEF NOTES
Plasma magnesium during hemolytic crisis in children with favism In a previous investigation, we noted a marked increase of serum magnesium during the hemolytic crisis in a few cases of favism I. Similar findings were also later reported by Ferlazzo et al.*. In the present paper, we report a study on plasma magnesium levels in 12 children with acute hemolytic anemia due to favism. MATERIALS AND METHODS
Twelve children (IO males, 2 females) were investigated, their ages ranging between I8 months and 8 years. At the time of admission, they all presented clear clinical signs of massive hemolysis {severe anemia, mild jaundice, hemoglobinuria), a history of previous ingestion of Vicia faba seeds, and were found to be enzymopenic (homozygotes or hemizygotes Gd (--) Med) in erythrocyte glucose-6-phosphate dehydrogenase. All cases were treated with blood transfusions during their hospital stay. Blood for the analysis was collected (in heparin): I. at time of admission to the hospital; 2. immediately after blood transfusion; 3. at 24, 48, 72 hours and 7 days after transfusion. Plasma magnesium was assayed by the titan yellow method according to Masson a. This technique has given satisfactory results in our laboratory, and the values obtained in normal subjectst, 4 are similar to those obtained with methods described more recently. RESULTS AND COMMENT Values of plasma magnesium at the various times are reported in Table I. Prior to transfusion, the plasma magnesium level was considerably higher than in normal children of comparable age. Immediately after transfusion, there was a significant decrease in Mg levels (P < o.oi); 24 h later, plasma magnesium decreased further (P < o.oi), and after 48 h it attained values which were comparable to those recorded in healthy children. "FABLE 1 PLASMA MAGNESIUM L E V E L S R E C O R D E D AT D I F F E R E N T T I M E S
No. of cases Mean values S.o. .
.
.
.
.
.
.
.
.
.
.
.
.
.
Before trans,
After trans.
After 24 h
After 48 h
After 7~ h
After 7 days
12
I2
I2
I2
8
I2
2.37 o.24 .
.
.
.
.
.
.
.
.
.
.
.
.
(mequiv/l)
.
.
.
2.2t o.27
2.ol o.28
1.8t o.x5
1.79 o.li
t.77
o.I3
. ...........
The increased level of plasma Mg might be due to tile massive breakdown of red cells, and possibly to its decreased renal excretion. The decrease of magnesiemia following transfusion can be explained by the dilution effected by transfused blood which shows an Mg level lower than normal (due, in turn, to dilution of donor's blood with ACD solution). A similar, though much more striking, decrease was Clin. CMm. Acta, 27 (i97o) 36¢-36I
36t
BRIEF NOTES
recorded by us during exchange transfusion with ACD blood s in newborn babies with hyperbilirubinemia. In our casc~, no electrocardiograms were taken" we never detected any signs of central nervous system depression, and for every patient the clinical course was favorable and uneventful.
Institute of Genetics of the Faculty of Science (Center .for Evolutionary Genetics of National Research Council) and Pediatric Clinic of Rome University (Italy)
G. F. SPENNATI L. BUSI~CO L. CO,CA E. BOTTt,~I
REFERENCES t E. BOTTINI, Boll. Soc. ltal. Biol. Sper., 36 (s96o) 91x. z A. FERt.AZZO, G. LOMBARDO, G. ARENA AND J. GUARNIERE, /i~aS$. Clin. Terap. Sci. Al~ini, 64 (x965) 69. 3 M. MASSON, Rev. Franf. l~tudes Clin. Biol., z (t957) 413. 4 L. Busx~co, G. F. SPENNATX AND L. SARTORI, Jlcta Paed. Latina, 21 (t968) 242. 5 E. BOTTINI, G. VENTURA0 G. COCCIANTE AND E. DE LUCA CARAPE~LA, Biol. 2Veonatorum, 12 (1968) Io2. Reprint address: E. Bottini, Ciinica Pediatrica dell'UniversitY, Roma, Italy.
Received September xS, x969 Clin. Chim, Acla, 27 (x97 o) 36o-36i