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Living with Hemolytic anemia due to glucophosphate isomerase deficiency

An inherited blood condition in which red blood cells break down early, from mild to severe anemia.

Understanding Hemolytic anemia due to glucophosphate isomerase deficiency

Hemolytic anemia due to glucophosphate isomerase (GPI) deficiency is an inherited condition that causes long-term anemia from red blood cell breakdown.

It ranges from mild to severe and begins in the newborn period or infancy. It can cause pale skin, yellowing of the skin and eyes (jaundice), tiredness, and fast heartbeat. People may also have an enlarged spleen and gallstones. Infections can trigger episodes of worse breakdown (hemolytic crises). A small number also have nervous system problems.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Anemia from red blood cell breakdown
  • Yellowing of skin and eyes (jaundice)
  • Enlarged spleen
  • Enlarged liver
  • More young red blood cells (reticulocytosis)
  • Gallstones

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include blood and bone marrow specialists and genetic specialists.

  3. Consider genetic testing

    Changes in GPI are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Blood and bone marrow specialists (hematologists); Genetic specialists (geneticists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with rare disease patient organizations for support
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Which infections or situations could trigger a hemolytic crisis?
Could genetic testing for the GPI gene help our family?
Should we watch for nervous system or learning problems?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive
GenesGPI

It is caused by changes in the GPI gene. It is autosomal recessive, so a child inherits a changed copy of the gene from each parent.

GeneticBloodInherited Metabolic

Also known as: anemia, congenital, nonspherocytic hemolytic, 4; anemia, congenital, nonspherocytic hemolytic, 4, glucose phosphate isomerase deficient; cnsha4; glucosephosphate isomerase deficiency; hemolytic anemia, nonspherocytic, due to glucose phosphate isomerase deficiency; hereditary nonspherocytic hemolytic anemia (hnsha) due to glucose phosphate isomerase deficiency

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Hemolytic anemia due to glucophosphate isomerase deficiencyGARD ID 16541 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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