Question

A patient from a Mediterranean country visits Africa, where he develops malaria. He is treated with primaquine and later develops hemolytic anemia. Deficiency of an enzyme involved in which of the following pathways could be the cause?

• A. Glycolysis
• B. Gluconeogenesis
• C. Hexose monophosphate (HMP) pathway
• D. Luebering-Rapoport pathway

Answer 1

The Correct Option is C

The patient, originating from the Mediterranean region, develops malaria, and upon treatment with primaquine, experiences hemolytic anemia. This suggests a deficiency in a specific enzyme—glucose-6-phosphate dehydrogenase (G6PD)—which is crucial in the hexose monophosphate (HMP) pathway, also known as the pentose phosphate pathway. This enzyme deficiency is prevalent among individuals from Mediterranean and African regions and leads to reduced production of NADPH. NADPH is essential for maintaining the reduced state of glutathione, which protects red blood cells from oxidative damage. Without sufficient NADPH, red blood cells become more susceptible to oxidative stress, especially when exposed to oxidative agents like primaquine, resulting in hemolysis and anemia.

Therefore, the deficiency of an enzyme in the HMP pathway can cause the observed symptoms in the patient.

Pathway Involved

Hexose Monophosphate (HMP) Pathway