Objective:

To report a case of acute hemolysis induced by rasburicase in a patient with undiagnosed G6PD deficiency, highlighting the importance of screening in patients undergoing treatment for chronic lymphocytic leukemia.

Key Findings:

• The patient experienced acute hemolysis within 24 hours of rasburicase administration.
• Laboratory tests indicated elevated bilirubin and decreased hemoglobin, consistent with hemolytic anemia.
• The patient had undiagnosed G6PD deficiency, contraindicating the use of rasburicase, which was a critical oversight.

Interpretation:

This case highlights the importance of screening for G6PD deficiency before administering rasburicase, particularly in patients at risk for tumor lysis syndrome, to prevent serious complications.

Limitations:

• G6PD assay was not performed prior to rasburicase administration, which is a critical oversight.
• The patient's missed doses of febuxostat may have contributed to the acute onset of tumor lysis syndrome.

Conclusion:

Healthcare providers should ensure thorough medication history and consider implementing specific genetic screening protocols for G6PD deficiency in patients receiving rasburicase to prevent hemolytic complications.