[Treatment of porphyria cutanea tarda with intermittent chloroquine]

Intermittent chloroquine medication was given to 15 patients with porphyria cutanea tarda. These are the advantages of the chloroquine treatment: The clinical signs of porphyria cutanea tarda and the liver-dysfunction are re-adjusted in short time. The equilibrium of porphyrin metabolism is restored by the transformation of the biochemical manifest porphyria cutanea tarda into a latent form.

Identification of two types of porphyria cutanea tarda by measurement of erythrocyte uroporphyrinogen decarboxylase

1. Erythrocyte uroporphyrinogen decarboxylase activity has been measured in 27 patients with porphyria cutanea tarda, of whom 11 had a family history of overt porphyria cutanea tarda. 2. Eight patients from six families had erythrocyte uroporphyrinogen decarboxylase activities that were decreased to about half of control values. This decrease was shown by family studies to be inherited as an autosomal dominant characteristic. Two of these patients had no family history of overt porphyria cutanea tarda. 3. Nineteen patients had uroporphyrinogen decarboxylase activities close to or within the range found in 18 control subjects. Of these, five patients had a family history of porphyria cutanea tarda. 4. Inheritance of an autosomal dominant gene which decreases uroporphyrinogen decarboxylase activity in erythrocytes and liver is an uncommon cause of porphyria cutanea tarda and may not explain all cases of familial porphyria cutanea tarda. The hepatic enzyme defect in the common type of porphyria cutanea tarda, in which erythrocyte uroporphyrinogen decarboxylase activity is normal, may be caused either by inheritance of a gene whose effect is restricted to the liver or by gene whose effect is restricted to the liver or by chemicals that selectively inhibit the hepatic enzyme.

Urinary porphyrin excretion in various types of porphyria. Thin-layer chromatographic study

A new method of thin-layer chromatography was used for the study of urinary porphyrins in 42 porphyric patients (27 cases of porphyria cutanea tarda (PCT), 5 cases of porphyria variegata, 4 cases of acute intermittent porphyria, 2 cases of hereditary coproporphyria and 4 cases of erythropoietic protoporphyria), 21 of their clinically normal relatives and 5 controls. The results are compared to previously published data and discussed for the diagnosis of the porphyrias. If urinary porphyrin pattern seems sufficiently pathognomonic for PCT, it appears often unable to allow exact diagnosis of the acute porphyrias; faecal studies and sometimes enzymatic determinations are necessary.

Photosensitivity and cutaneous acid hydrolases in porphyria cutanea tarda

In the present study the participation of lysosomal enzymes in the primary photosensitizing process in the skin of porphyric patients were investigated. Cutaneous photosensitivity reactions were produced in patients with porphyria cutanea tarda by irradiation with near UV light and also to a lesser degree with visible light. The reactions occurred almost exclusively in patients with urinary uroporphyrin excretion exceeding 900 nmol/24 h and preceeded any noticeable increase of lysosomal enzyme activity by several hours. These results indicate that lysosomal enzymes are not primarily involved in the photosensitizing reaction in porphyric patients but that they participate in the cutaneous inflammatory process in porphyric skin at a later stage.

Homologous radioimmunoassay for human epidermal growth factor (urogastrone)

Epidermal growth factor (EGF), a polypeptide hormone originally discovered in the mouse submaxillary gland, stimulates growth in a variety of tissues in several species. This hormone has recently been identified in human urine. A homologous RIA for human EGF (RIA-hEGF) has been developed. In general, levels were similar to those recently reported using a heterologous RIA system. Twenty-four-hour urinary excretion of RIA-hEGF by normal adult males and females was 63.0 +/- 3.0 and 52.0 +/- 3.5 (mean +/- SE) micrograms/total vol, or 29.7 +/- 1.1 and 39.8 +/- 1.7 micrograms/g creatinine, respectively. Excretion by females taking oral contraceptives was significantly greater (60.1 +/- 2.7 micrograms/g creatinine; P less than 0.01) than that by females who were not. Recent evidence suggests the probable identity of hEGF and beta-urogastrone, a potent inhibitor of gastric acid secretion. Adult males with active peptic ulcer disease appeared to have lower urinary RIA-hEGF excretion (22.9 +/- 2.6 micrograms/g creatinine) than normal men, but this was not significant (P greater than 0.05). Several of those with very low values had histories of alcohol abuse. Excretion by patients with Cushing's syndrome was normal. Patients with psoriasis or recovering from major burns excreted both abnormally high and abnormally low levels of RIA-hEGF, with no obvious correlation to their clinical condition. There was no apparent diurnal or postprandial variation in urinary RIA-hEGF excretion by normal subjects. An excellent linear correlation was observed between RIA-hEGF and creatinine concentrations in each urine sample for each subject, suggesting that RIA-hEGF concentration in a random urine sample provides a valid index of 24-h RIA-hEGF excretion.

Urinary excretion of indolyl-3-acryloylglycine in some skin affections

1. Urinary excretion of indolyl-3-acryloylglycine (chromogen of the so-called Kimmig's light band) in 15 normal subjects was highly significantly increased in June-September ("summer") against the November-April ("winter") collection in the same subjects. Possible explanation of this phenomenon is discussed. 2. In the "winter" period, the mean of 23 patients with chronic polymorphous light eruption was significantly higher than the mean of the 29 controls. In the "summer" period, though an increaes of the average against "winter" was also noted, this difference against the control group (29) disappeared. 3. In 24 patients with skin tuberculosis the mean excretion in "winter" was significantly higher than in controls. This increase cannot be simply attributed to heliotherapy. 4. In "winter", there was no significant difference between the normal subjects and 12 patients with lupus erythematosus and 10 patients with porphyria cutanea tarda. In both these groups there was marked "summer" increase in excretion, though in the case of porphyria cutanea tarda, the "summer" mean was significantly lower than that of the controls. 5. All results were expressed on creatinine basis. In part of the subjects it was possible to calculate the excretion per unit time. Identical conclusions could be drawn.

Vitamin B12 excretion in patients with various skin diseases

The excretion in the urine of (58)Co after an oral dose of (58)Co vitamin B(12) given together with intrinsic factor has been found to be reduced in a number of patients with psoriasis, eczema, and other less common dermatoses. There is a correlation between the abnormality and the extent of the rash. A reduced glomerular filtration rate was found in a few of the patients in whom it was measured, and this must have been responsible, at least in part, for the reduced excretion of vitamin B(12) in these patients, but abnormal vitamin B(12) excretion also occurred in the absence of impaired renal function. Our evidence is insufficient to show whether malabsorption or increased tissue utilization of vitamin B(12) was the explanation in other cases. Certainly a number of patients had steatorrhoea, and in these it is most likely that malabsorption was the major factor. In patients without steatorrhoea a lone malabsorption of vitamin B(12) cannot be excluded. A decreased serum concentration of vitamin B(12) was found in only one of the patients.

Urinary acid mucopolysaccharide excretion in skin disease

The urinary output of non-sulphated and sulphated acid mucopolysaccharides was measured in a group of psoriatic patients, a group of patients with other dermatoses, and a group of healthy controls. The total excretion of acid mucopolysaccharides was raised in both groups of patients, the increment being equally distributed between the non-sulphated and the sulphated fractions.