G6PD and G6PD deficiency: In summary, our case of primaquine-induced hemolysis in an aparasitemic patient with severe G6PD deficiency highlights that 1) hemolysis transiently increases baseline G6PD activity, 2) regular paracetamol can be given safely in G6PD-deficient patients with hemolysis, and 3) severe primaquine-induced hemolysis alone may cause not only tubular injury but likely also glomerular glycocalyx degradation and injury, presumably due to oxidative damage from cell free heme.