Introduction:
Hemolytic anemia, a form of anemia that causes premature rupture of erythrocytes, accounts for five percent of anemias[1]. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a well-known cause of hemolysis and currently affects around 400,000000 individuals globally. It has a notable prevalence in African, Asian, and Mediterranean countries [2]. Favism is a common trigger of oxidative stress in G6PD deficient people, which can lead to hemolysis. Additionally, fava bean ingestion can cause methemoglobinemia [3]. Methemoglobin is an abnormal variation in the hemoglobin in which the ferrous (Fe2+) iron in heme is oxidized to the ferric (Fe3+) state. The condition is usually acquired, secondary to oxidative stress in the body such as favism or infections, but can rarely be congenital[4]. The first-line treatment for methemoglobinemia is methylene blue. However, in G6PD deficient patients, methylene blue can potentiate hemolysis because of its oxidative effects [3]. It is vital to take a detailed history of patients presenting with hemolysis to identify the potential causes and avoid any additional oxidative stress.