Favism

Favism

Favism is a hemolytic response to the consumption of fava beans (also known as broad beans) or inhalation of pollen from the Vicia faba plant. This condition is most commonly associated with a deficiency in the enzyme glucose-6-phosphate dehydrogenase (G6PD), which is crucial for the proper functioning of red blood cells.

Pathophysiology

Favism occurs due to the oxidative stress induced by certain compounds found in fava beans, such as vicine and convicine. In individuals with G6PD deficiency, the red blood cells are unable to handle this oxidative stress, leading to hemolysis, or the destruction of red blood cells. This results in symptoms such as jaundice, anemia, and fatigue.

Epidemiology

Favism is most prevalent in regions where G6PD deficiency is common, such as the Mediterranean, Middle East, Africa, and parts of Asia. The prevalence of G6PD deficiency in these areas is thought to be an evolutionary response to malaria, as the deficiency provides some protection against the malaria parasite.

Symptoms

The symptoms of favism can vary in severity and may include:

• Sudden onset of jaundice
• Dark urine
• Fatigue
• Shortness of breath
• Rapid heart rate
• Abdominal pain

Diagnosis

Diagnosis of favism is typically based on the clinical presentation and a history of recent fava bean consumption. Laboratory tests can confirm hemolysis and G6PD deficiency. These tests include:

• Complete blood count (CBC)
• Reticulocyte count
• Serum bilirubin levels
• Direct antiglobulin test (Coombs test)
• G6PD enzyme assay

Treatment

The primary treatment for favism is the avoidance of fava beans and other known triggers of hemolysis in G6PD-deficient individuals. In cases of acute hemolysis, supportive care may be necessary, including:

• Blood transfusions
• Oxygen therapy
• Hydration

Prevention

Preventing favism involves educating individuals with G6PD deficiency about the risks associated with fava bean consumption and other potential triggers. Genetic counseling may be beneficial for families with a history of G6PD deficiency.

See also

• Glucose-6-phosphate dehydrogenase deficiency
• Hemolytic anemia
• Fava bean

References

• Luzzatto, L., & Arese, P. (2018). Favism and Glucose-6-Phosphate Dehydrogenase Deficiency. The New England Journal of Medicine, 378(1), 60-71.
• Cappellini, M. D., & Fiorelli, G. (2008). Glucose-6-phosphate dehydrogenase deficiency. The Lancet, 371(9606), 64-74.