Enzyme Deficiency States Research Articles

Blood Disorders Due to Drugs and Other Agents

This book is a welcome addition to the voluminous literature on drug-induced blood disorders. The introductory chapter is a general consideration of fundamental problems with therapeutic agents, drug interactions, host responses to drugs and problems related to the physician's judgment. Other chapters are concerned with hemolytic anemias, erythrocyte enzyme deficiency states, megaloblastic and hypoplastic anemias, agranulocytosis, and thrombocytopenic states. Each chapter is a comprehensive review of the subject, with profuse bibliographical citations (eg, 535 references in the chapter on agranulocytosis, dated through 1971). Nonhematological drug-induced diseases such as systemic lupus erythematosus are not included in the book. A more serious omission is the recently emphasized recognition that acute leukemia may be induced by the prolonged use of melphalan, chlorambucil, and other antineoplastic agents. Appropriately, an entire chapter is devoted to chloramphenicol, but one can question the inclusion of a chapter on hematological aspects of radiation in a book on drug-induced

Glucose-6-phosphate dehydrogenase activity in the red blood cells of monkeys.

IN human beings there exists an inborn character of the red blood cells which is usually harmless, but which, in certain individuals, can lead to severe hæmolysis if the red cells are challenged by the ingestion of certain drugs or foods. The main abnormality in these individuals is a deficiency of the enzyme glucose-6-phosphate dehydrogenase in the red cells, which usually have a correspondingly low amount of reduced glutathione in them. Further, when such sensitive red cells are incubated in certain chemicals, for example, acetylphenylhydrazine, there is a marked fall in the level of reduced glutathione, which does not occur with erythrocytes of normal persons. This is the glutathione stability test of Beutler1, and it has been pointed out by Beutler et al.2 that the glutathione instability of the drug-sensitive cells probably results from their deficiency in glucose-6-phosphate dehydrogenase. A simple test for demonstrating this enzyme deficiency state has been developed by Motulsky3.