Wanted to share an interesting story!
We are getting calls from our past patients regarding COVID vaccination. Many of my patients are taking immune suppressive drugs for various diseases.
I got a call from one such patient who originally hails from Jordan but now settled in Mumbai. She last saw me in 2010 when I was consulting at Bombay Hospital, Mumbai. I told her she can take the vaccine but her call reminded me of her case which I am discussing here.
She was 36 year old then and she was admitted to Bombay hospital with sudden drop in her hemoglobin level. She collapsed after returning back from a family wedding in Jordan. She was passing dark colored urine and had dark yellow eyes. I was called upon to see her and she was in a serious state and was admitted in ICU.
Her Hemoglobin level was only 3.2 gm/dl (normal: 12-14)! Her kidney function was deranged and she was started on oxygen therapy and steroid injections. Her husband said she has 2 episodes of low hemoglobin but none of them was this serious. Most of her routine tests to find the cause of low hemoglobin were non-conclusive.
Sudden onset low hemoglobin with jaundice suggests that her red blood cells were “damaged” whilst in her body and hence the rapid drop in hemoglobin.
She had returned from a wedding and she had “Mehendi” or Henna applied to her arms and legs and with the blood picture I thought of a possible cause! She was diagnosed to have a hereditary condition called “G6PD” deficiency which is an enzyme and its deficiency makes our red cells prone to injury and hence low hemoglobin!
People who have this deficiency can get sudden onset low hemoglobin if they are exposed to certain drugs or food products. Mehendi is also one external chemical which is known to cause low hemoglobin (hemolysis).
So our patient had sudden onset anemia or low hemoglobin due to Mehendi she applied whilst attending the marriage!
The disease (G6PD) is common in Arab countries and Africa. The type seen in India is a milder form…so I am not telling you “stay away” from mehendi! As a doctor, gathering information is important and you as a patient should tell everything to your doctor!
August 2023
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