Pelvic pain, low blood pressure, and hemolysis after outpatient hysteroscopy in a patient with glucose-6-phosphate dehydrogenase deficiency

Abstract

Objective To report hemolytic crisis in a woman with glucose-6-phosphate dehydrogenase (G6PD) deficiency who underwent diagnostic hysteroscopy using endoscopic instruments sterilized in gluteraldehyde and phenol disinfectant. Design Case report. Setting Surgical unit of a university hospital. Patient(s) A 53 year-old woman with endometrial thickening on ultrasonography. Intervention(s) Diagnostic hysteroscopy. Main outcome measure(s) Laboratory tests. Result(s) The patient experienced abdominal pain and acute hypotension 10 minutes after diagnostic hysteroscopy. We attributed this event to the exposure of her genital mucosa caused by the hysteroscopic chemical disinfectant. Conclusion(s) Chemical sterilization of endoscopes can cause clinical manifestations in people with G6PD deficiency, a common enzyme abnormality. The phenol content in some chemical disinfectants for endoscopic instruments can also cause hemolytic crisis.