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Hexokinase deficiency
Hexokinase deficiency
Other names	HK deficiency, Non-spherocytic hemolytic anemia due to hexokinase deficiency, NSHA due to HK1 deficiency, and Hexokinase deficiency hemolytic anemia.
	Hexokinase deficiency is an autosomal recessive disorder.
Specialty	Hematology

Hexokinase deficiency is an extremely rare autosomal recessive condition that falls under the category of erythroenzymopathies, or defects in red cell enzymes.^[2] Hexokinase deficiency manifests is associated with chronic nonspherocytic hemolytic anemia.^[3] Hemolytic anemia seems to be the only clinical sign of hexokinase deficiency.^[4] In 1967 the first case of hexokinase deficiency was described by Valentine et al,^[5] since then, less than 50 cases have been reported.^[6]

Signs and symptoms

The main clinical feature of affected individuals is mild to severe hemolytic anemia that lasts a lifetime. However, there have also been rare reports of multiple malformations, including psychomotor retardation.^[7] Intrauterine fetal death results from a total loss of HK1 expression.^[8]

Hemolytic anemias' systemic symptoms, which include weakness, pallor, exhaustion, and dizziness, are similar to those of other anemias. There may be splenic icterus, jaundice, and/or splenomegaly.^[9]

Extremely impacted people may develop neonatal hyperbilirubinemia and subsequently need transfusions on a regular basis to treat their uncontrollable anemia. Anemia is absent and hemolysis is completely compensated for, for those with mild disease. Nonetheless, these patients typically have reticulocytosis, splenomegaly, and jaundice. Gallstones can be seen as early as childhood.^[6]

Diagnosis

Treatment

Treatment includes red cell transfusions as needed, supplemental folic acid, and close monitoring for cholelithiasis. Splenectomy may alleviate anemia but does not cure it.^[6]

References

^ "Monarch Initiative". Monarch Initiative. Retrieved December 18, 2023.
^ Koralkova, Pavla; Mojzikova, Renata; van Oirschot, Brigitte; Macartney, Christine; Timr, Pavel; Vives Corrons, Joan Lluis; Striezencova Laluhova, Zuzana; Lejhancova, Katerina; Divoky, Vladimir; van Wijk, Richard (2016). "Molecular characterization of six new cases of red blood cell hexokinase deficiency yields four novel mutations in HK1". Blood Cells, Molecules and Diseases. 59. Elsevier BV: 71–76. doi:10.1016/j.bcmd.2016.04.002. ISSN 1079-9796. PMID 27282571.
^ Koralkova, P.; van Solinge, W. W.; van Wijk, R. (2014). "Rare hereditary red blood cell enzymopathies associated with hemolytic anemia – pathophysiology, clinical aspects, and laboratory diagnosis". International Journal of Laboratory Hematology. 36 (3): 388–397. doi:10.1111/ijlh.12223. ISSN 1751-5521. PMID 24750686.
^ Valentine, WN; Paglia, DE (September 1, 1984). "Erythrocyte enzymopathies, hemolytic anemia, and multisystem disease: an annotated review". Blood. 64 (3). American Society of Hematology: 583–591. doi:10.1182/blood.v64.3.583.583. ISSN 0006-4971. PMID 6235866.
^ Valentine, William N.; Oski, Frank A.; Paglia, Donald E.; Baughan, Marjorie A.; Schneider, Arthur S.; Naiman, J. Lawrence (January 5, 1967). "Hereditary Hemolytic Anemia with Hexokinase Deficiency". New England Journal of Medicine. 276 (1). Massachusetts Medical Society: 1–11. doi:10.1056/nejm196701052760101. ISSN 0028-4793. PMID 6015552.
^ ^a ^b ^c Mentzer, Jr., William C. (November 14, 2014). "Hemolytic Anemias". Nathan and Oski's Hematology and Oncology of Infancy and Childhood, 2-Volume Set (8 ed.). Saunders. pp. 582–585. ISBN 9780323291774. Retrieved 18 December 2023.
^ Goebel, K. M.; Gassel, W. D.; Goebel, F. D.; Kaffarnik, H. (1972). "Hemolytic anemia and hexokinase deficiency associated with malformations". Klinische Wochenschrift. 50 (17). Springer Science and Business Media LLC: 849–851. doi:10.1007/bf01496345. ISSN 0023-2173. PMID 5076409. S2CID 11829430.
^ Kanno, Hitoshi; Murakami, Koko; Hariyama, Yumi; Ishikawa, Kaoru; Miwa, Shiro; Fujii, Hisaichi (September 1, 2002). "Homozygous intragenic deletion of type I hexokinase gene causes lethal hemolytic anemia of the affected fetus". Blood. 100 (5). American Society of Hematology: 1930. doi:10.1182/blood-2002-05-1599. ISSN 1528-0020. PMID 12211198.
^ Braunstein, Evan M. (June 13, 2022). "Overview of Hemolytic Anemia". Merck Manuals Professional Edition. Retrieved December 18, 2023.