1. ¹Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2. ²Faculty of Medicine of the Hebrew University, Jerusalem, Israel
3. ³Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

Correspondence: Dr M Kaplan, Department of Neonatology, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel. E-Mail: kaplan@cc.huji.ac.il

Received 4 September 2007; Revised 29 October 2007; Accepted 28 November 2007.

Abstract

A premature glucose-6-phosphate dehydrogenase (G-6-PD) deficient neonate was readmitted for exponential rise in the plasma bilirubin concentration to 33.0 mg dl^-1. Blood carboxyhemoglobin (2.8% of total hemoglobin, >threefold normal value) confirmed the presence of hemolysis; however, hematological indices were unchanged from the birth hospitalization. Serum unbound bilirubin, although present, was probably at a concentration insufficient to cause bilirubin encephalopathy. In G-6-PD deficient neonates, severe hemolysis may occur in the absence of hematological changes typical of a hemolytic process.