{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:40:22Z","timestamp":1756363222194,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,18]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Rasburicase is a recombinant urate oxidase enzyme indicated in patients at a high risk of tumour lysis syndrome. Rasburicase is contraindicated in patients with glucose-6-phosphate-dehydrogenase (G6PD) deficiency, given the risk of precipitating oxidative stress, haemolytic anaemia, as well as methemoglobinemia. We present a case of a man in his 40s without risk factors for G6PD deficiency, who after rasburicase administration developed severe haemolytic anaemia and hypoxia. Although studies validating the use of rasburicase were at a dosage of 0.2\u2009mg\/kg up to 5\u2009days, there are new studies suggesting a lower dose such as 3\u2009mg be just as efficacious in normalising uric acid. There is no evidence to date suggesting higher risk of haemolytic anaemia with increased dosage of rasburicase, but this case highlights the need to assess on a broader level whether 3\u2009mg as a one-time dose should be the new standard of care or whether lower dosages are safer for patients.<\/jats:p>","DOI":"10.1136\/bcr-2024-262830","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T08:23:09Z","timestamp":1743409389000},"page":"e262830","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rasburicase-induced methemoglobinemia and haemolytic anaemia in a patient with G6PD deficiency"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6668-3249","authenticated-orcid":false,"given":"Nitya","family":"Surya","sequence":"first","affiliation":[{"name":"Internal Medicine, Tufts Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cherng-Horng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Tufts Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Ryan","sequence":"additional","affiliation":[{"name":"Internal Medicine, Tufts Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"2025082723070584000_18.3.e262830.1","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1053\/j.ackd.2021.09.007","article-title":"Tumor Lysis Syndrome","volume":"28","author":"Barbar","year":"2021","journal-title":"Adv Chronic Kidney Dis"},{"key":"2025082723070584000_18.3.e262830.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08143.x"},{"key":"2025082723070584000_18.3.e262830.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0904569"},{"key":"2025082723070584000_18.3.e262830.4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.0177"},{"key":"2025082723070584000_18.3.e262830.5","doi-asserted-by":"crossref","first-page":"597","DOI":"10.2147\/OTT.S103864","article-title":"Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase","volume":"10","author":"Alakel","year":"2017","journal-title":"Onco Targets Ther"},{"key":"2025082723070584000_18.3.e262830.6","first-page":"471","article-title":"Rasburicase-induced Hemolytic Anemia in an Adolescent With Unknown Glucose-6-Phosphate Dehydrogenase Deficiency","volume":"22","author":"Akande","year":"2017","journal-title":"J Pediatr Pharmacol Ther"},{"key":"2025082723070584000_18.3.e262830.7","doi-asserted-by":"crossref","first-page":"3399","DOI":"10.1007\/s00277-023-05364-6","article-title":"Rasburicase-induced hemolytic anemia and methemoglobinemia: a systematic review of current reports","volume":"103","author":"Hammami","year":"2024","journal-title":"Ann Hematol"},{"key":"2025082723070584000_18.3.e262830.8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.clml.2015.12.001","article-title":"Imatinib Increases Serum Creatinine by Inhibiting Its Tubular Secretion in a Reversible Fashion in Chronic Myeloid Leukemia","volume":"16","author":"Vidal-Petiot","year":"2016","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"2025082723070584000_18.3.e262830.9","unstructured":"Highlights of prescribing information. n.d. 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