G6PD and autoimmune hemolytic anemia: Primaquine metabolism produces reactive oxygen species (ROS), which rapidly deplete glutathione in G6PD-deficient erythrocytes: the crucial role of glutathione in ROS-related hemolysis is demonstrated by the fact that very rare patients with glutathione reductase deficiency can suffer attacks of acute hemolytic anemia (AHA) very similar to those of G6PD-deficient persons.6 Glutathione depletion is followed by damage to hemoglobin and presumably to other intraerythrocytic and membrane proteins.