The patient, male, aged 36, suffered from pharynx and fever after a cold. He was admitted to a local hospital for fever. He was diagnosed with upper respiratory tract infection and treated with levofloxacin. After intravenous infusion of 0.2g levofloxacin, chills, low back pain and sclerotic yellow staining occurred. After examination, He was suffering from “Favism”, and the activities of glucose and -6- phosphate dehydrogenase (G-6-PD) in patients themselves and their children were slightly decreased.
I. What is Favism?
G-6-PD deficiency is due to the defect of G-6-PD on the erythrocyte membrane, which reduces the production of reducing glutathione that maintains the stability of erythrocyte membrane. An inherited disease that resists oxidative damage and eventually leads to red blood cell destruction and hemolysis. Patients often develop disease due to the consumption of fava beans.
Favism, which is a hereditary disease, affects about 7:1 males and females.
II. Which drugs can induce Favism?
Patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, most of whom have no clinical symptoms for life, do not usually affect lifespan and quality of life in the absence of disease. Some severe patients can cause severe neonatal hyperbilirubinemia, or life-threatening infections, food or drugs that induce non-immune hemolysis.
Any person who uses the following substances, or comes in contact with the following substance, should have immediate medical attention if symptoms such as general malaise, fatigue, fever, chills, pale complexion, jaundice, low back pain, and urine tan or dark redness appear within hours or days!
III. How to prevent Favism?
1. Prudent use of proprietary Chinese medicines
It has been confirmed that berberine hydrochloride can induce “Favism”. Chinese herbal medicines such as Coptis chinensis, Phellodendron chinense, celandine, maweilian, three-needle, madam, etc. all contain berberine. Therefore, patients with Favism should avoid the use of proprietary Chinese medicines containing these herbs.
2. Avoid using compound cold medicine
Compound cold medicines usually contain acetaminophen, aspirin, and chlorpheniramine. All three drugs can induce Favism. Therefore, patients with Favism should avoid using the compound cold medicine.
Ibuprofen can be used when antipyretic analgesics are used.
3. Fasted broad beans and products
Any person suffering from the disease or a family member who has suffered from this disease, whether it is an adult or a child, shall prohibit food, cooked broad beans, and stay away from the pollen of broad bean.
The mother’s feeding after faba bean may cause the infant to become ill. Therefore, breast-feeding women are advised not to eat raw and cooked broad beans during breast-feeding so as to prevent the infant from developing the disease through sucking milk.
4. Stay away from mothballs
Clothes that are moth-eaten using mothballs may cause hemolytic reactions in children through contact, so try not to wear clothing stored in mothballs.