Rasburicase is considered for rapid lowering of serum urate before chemotherapy in a patient with bulky lymphoma. Screening for which condition is mandatory before giving this drug?

• A Hereditary fructose intolerance
• B Methylenetetrahydrofolate reductase polymorphism
• C Glucose-6-phosphate dehydrogenase deficiency ✓
• D Pyruvate kinase deficiency

Explanation

Rasburicase is a recombinant urate oxidase that converts uric acid to allantoin, and its action generates hydrogen peroxide as a byproduct. In glucose-6-phosphate dehydrogenase deficiency, red cells cannot handle this oxidative load and severe haemolysis with methaemoglobinaemia can occur, so G6PD status must be checked before use. Pegloticase carries the same concern. The other conditions listed do not predispose to oxidant haemolysis from peroxide generation.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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