Favism in England--two More Cases.

Viciafaba (L), the broad bean, contains a potentially toxic substance, the exact nature of which is unknown, capable of producing a haemolytic crisis in a susceptible person. The crisis may be induced by eating the beans raw or, less commonly, cooked, and in some cases by inhalation of the bean pollen. The erythrocytes of susceptible individuals are deficient in the enzyme glucose-6-phosphate dehydrogenase (G6PD). The defect is transmitted as a sexlinked dominant trait, and shows a variable degree of penetrance (Hargreaves, 1963). Favism cannot, however, be induced in all those people who are deficient in erythrocyte G6PD, which suggests that there is a second abnormality in patients with this disease, which has yet to be defined. Favism has been known for many centuries along the Mediterranean littoral, and it may have been one reason why Pythagoras forbade his followers to eat beans and he himself was slain rather than set foot in a bean field (Arie, 1959). The condition was first described in Britain only 11 years ago in two Cypriots (Diggle, 1953), and since then only five other cases have been reported in this country. These included a Cypriot child (Gower and Frommer, 1960), an English child of Mediterranean ancestry (Discombe and Mestitz, 1956), an English child (McCarthy, 1955), and two English women 03rodribb and Worssam, 1961; Davies, 1962). In spite of the ubiquity of the broad bean and the recent increase in immigration from the Mediterranean area, this potentially lethal, yet largely preventable, condition remains little known and rarely described in this country. It may well become more common, and this report of two further cases, one of which might have proved fatal, will serve as a reminder of its existence.