Detection of G6PD Deficiency and Its Impact on Red Blood Cell Indices in Patients with β-Thalassemia Trait and Sickle Cell Disease

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common X-linked enzymatic disorder that impairs the antioxidant defense of red blood cells. Hemoglobinopathies, particularly β-thalassemia trait and sickle cell disease (SCD), are prevalent inherited disorders causing anemia and alterations in red cell indices. Coinheritance of G6PD deficiency with these conditions may further influence hematological status. OBJECTIVE: To evaluate the frequency and hematological impact of G6PD deficiency among patients with β thalassemia trait and sickle cell disease. PATIENTS AND METHODS: A cross-sectional analytical study was conducted on 100 patients (55 males, 45 females) aged 3–45 years with clinically confirmed β-thalassemia trait or sickle cell disease, recruited from Al-Batool and Baqubah Teaching Hospitals in Diyala, Iraq between January and September 2025 .Venous blood samples were collected in K₃EDTA tubes and analyzed within 24 hours. Complete blood count (CBC) was performed using an automated hematology analyzer.G6PD activity was measured spectrophotometrically . RESULTS: Among 100 patients with sickle cell disease and β-thalassemia trait, G6PD deficiency was detected in 9% of cases. The prevalence was higher in males (10.9%) than females (6.7%). It was observed in 8.3% of patients with β-thalassemia trait and 10.7% of those with sickle cell disease, without a statistically significant difference between the two groups. Enzyme activity was significantly lower in males (mean 1.69 ± 0.18 U/g Hb) compared with females (2.88 ± 0.88 U/g Hb; p = 0.011). Regarding red cell indices, G6PD deficiency exerted a measurable hematological impact in both β-thalassemia trait and sickle cell disease, manifested by lower hemoglobin, hematocrit, and red blood cell counts, with increased indicators of erythropoietic activity. CONCLUSION: (G6PD) deficiency constitutes a relevant comorbidity among patients with hemoglobinopathies in the studied population and was associated with more pronounced alterations in red blood cell parameters within the studied cohort.