Fava bean disease is an acute hemolytic anemia that occurs in people with glucose hexaphosphate dehydrogenase (G6PD) deficiency after eating fava beans.

Fava bean disease is found in the southwest, south, east and north of China, with Guangdong, Sichuan, Guangxi, Hunan and Jiangxi being the most common. 70% of the patients are under the age of 3, and 90% of the patients are male. Adult patients are rare, but there are a few patients who develop the disease for the first time in middle age or old age. Since G6PD deficiency is hereditary, more than 40% of cases have a family history. The disease often occurs in early summer when fava beans are ripe. The vast majority of patients develop the disease after eating fresh fava beans. The onset of the disease may be late or early depending on the climate in the north and south.

The incidence of fava bean disease is quite complicated, such as fava bean disease only occurs in G6PD-deficient people, but not all G6PD-deficient people eat fava beans after hemolysis occurs; once the occurrence of fava bean disease people eat fava beans every year, but not necessarily every year the onset of the disease; onset of the degree of hemolysis and anemia and the amount of fava beans eaten is not parallel to the amount of the incidence of adults significantly lower than the incidence of pediatrics. It can be hypothesized that in addition to the lack of G6PD in red blood cells, there must be other factors related to the onset of the disease. It can be seen that the mechanism of hemolysis in fava bean disease is more complex than that of drug-induced hemolytic anemia due to G6PD deficiency, which needs to be further explored.

Clinical manifestations

Fava bean disease has a rapid onset, and hemolysis occurs within 1 to 2 days after eating fresh beans, with the shortest time being only 2 hours and the longest time being 9 days. If the disease is caused by inhalation of pollen, symptoms may appear within minutes. The length of the incubation period is independent of the severity of symptoms.

The degree of anemia and symptoms of the disease are mostly severe. Symptoms include general malaise, fatigue, chills, fever, dizziness, headache, anorexia, nausea, vomiting, and abdominal pain. The sclera is mildly yellowish and the urine color is like strong red tea or even like soy sauce. Symptoms last from 2 to 6 days in average cases. The most severe cases show signs of acute circulatory failure and acute renal failure such as extreme pallor, generalized exhaustion, weak and rapid pulse, drop in blood pressure, slowness or irritability, oliguria or occlusion of urine. If the anemia, hypoxia and electrolyte imbalance are not corrected in time, it can be fatal; however, if appropriate treatment can be given in time, there is still hope for improvement.

Diagnosis and prevention of fava beans

The sudden onset of severe acute hemolytic anemia after eating fresh fava beans is the main feature of fava bean disease, combined with the onset of the season, the region of onset, the patient's age, sex, and family history, etc., it is generally not difficult to make a diagnosis. If it can be proved that the patient's erythrocytes are deficient in glucose six-phosphate dehydrogenase (G6PD), the diagnosis will be more definite. In low-prevalence areas, the disease is easily overlooked and missed.

Haemolysis in serosanguineous disease is often rapid and massive, and the anemia is so severe that it requires prompt transfusion or input of concentrated red blood cells. Most patients after blood transfusion 1 to 2 times after the condition is improved. Attention should be paid to water and electrolyte balance. Drink more water or intravenous fluid infusion to prevent acute renal failure and potassium toxicity. Low blood pressure can be added to the infusion of low molecular dextrose to improve blood circulation.

Patients and those with known G6PD deficiency should avoid further consumption of fava beans or contact with fava flowers.

Fava bean disease has a rapid onset, with hemolysis occurring mostly within 1 to 2 days of eating fresh fava beans, with the shortest time being only 2 hours and the longest time being 9 days apart. If the disease is caused by inhalation of pollen, symptoms may appear within minutes. The length of the incubation period is independent of the severity of symptoms.

The degree of anemia and symptoms of the disease are mostly severe. Symptoms include general malaise, fatigue, chills, fever, dizziness, headache, anorexia, nausea, vomiting, and abdominal pain. The sclera is mildly yellowish and the urine color is like strong red tea or even like soy sauce. Symptoms last from 2 to 6 days in average cases. The most severe cases show signs of acute circulatory failure and acute renal failure such as extreme pallor, generalized exhaustion, weak and rapid pulse, drop in blood pressure, slowness or irritability, oliguria or occlusion of urine. If the anemia, hypoxia and electrolyte imbalance are not corrected in time, it can be fatal; however, if appropriate treatment is given in time, there is still hope for improvement.

The sudden onset of severe acute hemolytic anemia after eating fresh fava beans is the main feature of fava bean disease, combined with the onset of the season, the region of the onset, the patient's age, gender, and family history, etc., it is generally not difficult to make a diagnosis. If it can be proved that the patient's erythrocytes are deficient in glucose six-phosphate dehydrogenase (G6PD), the diagnosis will be more definite. In low-prevalence areas, the disease is easily overlooked and missed.

Hemolysis in serous disease is often rapid and massive, and the anemia is severe enough to require prompt transfusion or input of concentrated red blood cells. Most patients after blood transfusion 1 to 2 times after the condition is improved. Attention should be paid to water and electrolyte balance. Should drink more water or intravenous fluid infusion to prevent acute renal failure and potassium poisoning. Low blood pressure can be added to the infusion of low molecular dextrose to improve blood circulation.

Patients and those with known G6PD deficiency should avoid further consumption of fava beans or contact with fava flowers.

Prognosis of the disease: without proper treatment, severe cases can result in death due to acute anemia, potassium toxicity and acute renal failure. If appropriate treatment measures can be taken in a timely manner, the condition of most patients can rapidly improve, out of danger.

The official medical name for serotonin is "glucose-hexose-phosphate dehydrogenase deficiency". It is a congenital disease that affects a slightly higher percentage of Hakka people in Taiwan than others. The red blood cells of these patients are deficient in an enzyme, glucose-hexa-phosphate dehydrogenase, and when the body comes into contact with certain ingredients or chemicals, the red blood cells are susceptible to hemolytic reactions.

Fava bean disease is sexually transmitted, often from mother to son. There are several types of GBS depending on the type of enzyme deficiency, with the severity of the disease being the most appropriate level of differentiation. The degree of hemolysis at the onset of symptoms is related to the enzyme deficiency and the strength of the stimulus. If the stimulus is a drug, the greater the oxidizing power of the drug or the higher the dosage, the greater the hemolysis. Some hemolytic reactions are not caused by drugs, but may be due to microbial infections, certain pathologies such as diabetic ketoacidosis, some unknown causes occurring in the neonatal period, or the consumption of fava beans. Because these patients tend to bleed when they eat fava beans, they are commonly called fava bean disease.

In their daily lives, patients with fava bean disease should pay attention to several things, including avoiding eating fava beans, not using mothballs in closets and toilets, not using disinfectant containing gentian violet, such as violet drops, when injured, and not taking adult medicines on their own when they are sick, but consulting a physician or pharmacist. Before seeing a doctor and taking medication, you should also inform your physician or pharmacist that you are suffering from serotonin.

Serotonin patients should avoid the following medications:

I. Anti-malarial drugs, such as primaquine, pamaquine, pentaquine, plasmoquine.

II. Sulfonamides in anti-infective medications, for example sulfanilamidesulfapyridine, sulfisoxazole, sulfacetamide, salicylazosulfapyridine, sulfamethoxypyridazine.

Thirdly, antipyretic and analgesic agents, for example, aspirin acetanilide, phenacetin, antipyrine, aminopyrine, p-aminosalicylic acid.

IV. Certain anti-infective or antiseptic agents, e.g. nitrofurantoin, furazolidone, furaltadone.

VI.

V. Other chemicals, e.g., tartrazine (naphthalene), gentian violet, methylene blue, phenylhydrazine, acetylphenylhydrazine, probenecid (uric acid-lowering agent), sulfoxonoe.(medical village)

Precautions

1. Do not take medications at random, all medications are to be prescribed by a physician.

2. Avoid eating fava beans or their products (fava bean crisps).

3. Don't put pills in the closet or toilet.

4. Do not use gentian violet (violet drops).

5. If you have jaundice, anemia, or dark red urine, go to the hospital.

6. At the time of the visit, you should tell the health care provider that you have the disease and show the G-6-PD deficiency memo card.

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