# Syncope in the Emergency Department: A Case Report of a Rare Presentation of Favism

## TL;DR

A 69-year-old Iranian man experienced syncope due to a rare case of favism, a G6PD deficiency triggered by fava bean consumption.

## Contribution

This case report highlights the importance of diagnosing G6PD deficiency in elderly patients presenting with haemolytic crisis.

## Key findings

- The patient's syncope was caused by a haemolytic crisis due to undiagnosed G6PD deficiency.
- Methemoglobinaemia and hemighosts on blood smear aided in diagnosing favism.
- The case emphasizes the need to consider G6PD deficiency in elderly patients with haemolytic crises.

## Abstract

Consumption of fava beans in a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency, also called favism, can lead to a haemolytic crisis. We report the case of a 69-year-old patient of Iranian origin admitted to the emergency department following syncope. The patient's comprehensive interview and blood analysis revealed that the patient presented a haemolytic crisis triggered by fava beans consumption, due to previously undiagnosed G6PD deficiency. The pathophysiology of favism is complex and clinical presentations of G6PD deficiency are numerous due to multiple genetic variants. Indirect signs, such as the presence of methemoglobinaemia and hemighosts on the blood smear, can aid in the diagnosis. This case highlights the importance of considering G6PD deficiency as a potential diagnosis in case of haemolytic crisis, even in elderly patients.