A New Exon 9 Glucose-6-phosphate Dehydrogenase Mutation (G6PD “Rehovot”) in a Jewish Ethiopian Family with Variable Phenotypes

Hereditary nonspherocytic hemolytic anemia (HNSHA) is a rare manifestation of glucose-6-phosphate dehydrogenase (G6PD) gene mutations, caused mainly by mutations located in exon 10 of the G6PD gene and less commonly by mutations in other parts of the gene. A new, exon 9, single-base mutation representing a T → C transition at cDNA nucleotide 964 was found in three brothers and their carrier mother of Jewish Ethiopian descent. Biochemical characterization of the resultant protein was not performed. Though clinical manifestations included HNSHA in all cases, the severity of hemolysis and the transfusion requirement differed markedly. Severe congenital neutropenia (Kostmannʹs syndrome)—a disorder never reported before in conjunction with G6PD deficiency—was observed in one case. Levels of white blood cell G6PD activity of the three patients were 0–5% of normal controls. Neutrophil oxidative and bactericidal activities were inherently impaired in the patient with Kostmannʹs syndrome, but were well preserved in his two siblings.