• Husam Al-Dubai, Abdulrahman Al-Mashdali, and Yousef Hailan.
• Internal Medicine Department, Hamad General Hospital, HMC, Doha, Qatar.
• Medicine (Baltimore). 2021 Nov 24; 100 (47): e27904e27904.

RationaleFavism is a well-known cause of acute hemolytic anemia. Rarely, methemoglobinemia can also happen because of fava bean ingestion in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Few cases with this co-occurrence have been reported in the literature.Patient ConcernsWe report a case of a 47-year-old patient who presented with jaundice that started 2 days after eating fava beans.DiagnosesLaboratory investigations revealed anemia with evidence of hemolysis (high reticulocytes count, high indirect bilirubin, bite cells in peripheral smear). Blood gases showed high methemoglobin level. Reduced level of G6PD enzyme confirmed the diagnosis of G6PD deficiency.InterventionThe patient was kept on supplemental oxygen. He was counselled to avoid food and drugs that can cause acute hemolysis.OutcomesOxygen saturation improved gradually. The patient was discharged without any complications after 2 days.LessonsPatients with G6PD deficiency can develop both acute hemolytic anemia and methemoglobinemia secondary to fava beans ingestion. These patients should not receive methylene blue to avoid worsening hemolysis.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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