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[5] Most people who develop symptoms are male, due to the X-linked pattern of inheritance, but female carriers can be affected due to unfavorable lyonization or skewed X-inactivation, where random inactivation of an X chromosome in certain cells creates a population of G6PD-deficient red blood cells coexisting with unaffected red blood cells

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10.1002/smll.202303438 36 LiB.ChenX.QiuW.ZhaoR.DuanJ.ZhangS.et al (2022d)