A 30-year-old man presents to the emergency department with shortness of breath and dark urine for the last 1 day. He has recently returned from a vacation in Southeast Asia. He was prescribed medications by the local doctor for urinary tract infection. Vital signs are within normal limits are normal except for a heart rate of 115 beats/minute. Physical examination is unremarkable except for tachycardia. Laboratory studies show hemoglobin of 8 g/dL, normal mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC), elevated lactate dehydrogenase (LDH), and increased urine urobilinogen. Peripheral smear is notable for bite cells.
Which of the following enzymes is affected by the cofactor deficiency in this patient?
- A) Glutamate decarboxylase
- B) Glutamate oxaloacetate decarboxylase
- C) Glutaminase
- D) Glutathione peroxidase
- E) Glutathione reductase
Dr. Ted O'Connell