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Lindemann H, Diehl-Wiesenecker E, Gerischer L, Frank J. [An overview of porphyrias]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00105-024-05370-3. [PMID: 38902527 DOI: 10.1007/s00105-024-05370-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 06/22/2024]
Abstract
Porphyrias are predominantly genetic metabolic disorders caused by dysregulation of specific enzymes in porphyrin-heme biosynthesis. The enzymatic dysfunction leads to formation and excretion of intermediate metabolic products in the form of porphyrins and/or their precursors δ‑aminolevulinic acid and porphobilinogen, which have cyto- and tissue-toxic properties. Clinically, porphyrias are extremely diverse, with symptoms ranging from skin changes on light-exposed areas of the body to potentially life-threatening neurovisceral attacks. Biochemical tests in urine, blood and stool are used for diagnosis, which can be supplemented by molecular genetic analyses. Treatment of the various forms of porphyria is complex and often requires close interdisciplinary cooperation between different medical specialties.
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Affiliation(s)
- Hanna Lindemann
- Klinik für Dermatologie und Allergologie, Universitätsspital Basel, Basel, Schweiz
| | - Eva Diehl-Wiesenecker
- Innere Medizin mit Gastroenterologie und Nephrologie, Zentrale Notaufnahme, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Lea Gerischer
- Klinik für Neurologie mit Experimenteller Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Robert Koch Str. 40, 37075, Göttingen, Deutschland.
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2
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Shafique DA, Weiss AN, McCann SE. Sun-Induced Rash in a 6-year-old Girl. Pediatr Rev 2023; 44:466-469. [PMID: 37525306 DOI: 10.1542/pir.2021-005359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
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3
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Barman-Aksözen J, Minder AE, Granata F, Pettersson M, Dechant C, Aksözen MH, Falchetto R. Quality-Adjusted Life Years in Erythropoietic Protoporphyria and Other Rare Diseases: A Patient-Initiated EQ-5D Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5296. [PMID: 37047912 PMCID: PMC10094018 DOI: 10.3390/ijerph20075296] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Erythropoietic protoporphyria (EPP) is an ultra-rare inborn error of metabolism characterised by painful phototoxic burn injuries after short exposure times to visible light. Patients with EPP are highly adapted to their condition which makes the quantification of their health-related quality of life (QoL) challenging. In the presented patient-initiated feasibility study, we describe a new approach to assess treatment benefits in EPP by measuring QoL with the generic EQ-5D instrument in five patients under long-term (≥two years) treatment with afamelanotide, the first approved therapy for EPP. For the study, we selected patients with EPP who in addition were affected by an involuntary treatment interruption (caused by a temporary reimbursement suspension) because we hypothesized that individuals who had previously unlearned their adaptation are better able to assess their life without treatment than treatment-naïve patients. QoL under treatment was comparable to the age-matched population norm, and retrospective results for a treatment interruption and phototoxic reaction time point were comparable to the QoL of patients with chronic neuropathic pain and acute burn injuries, respectively. The results were accepted by the National Institute for Health and Care Excellence in England for their evaluation of the cost-effectiveness of afamelanotide, i.e., the calculation of quality-adjusted life years.
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Affiliation(s)
- Jasmin Barman-Aksözen
- International Porphyria Patient Network (IPPN), 8032 Zurich, Switzerland
- Institute of Laboratory Medicine, Municipal Hospital Zurich Triemli, 8063 Zurich, Switzerland
- Swiss Reference Centre for Porphyrias, Municipal Hospital Zurich Triemli, 8063 Zurich, Switzerland
| | - Anna-Elisabeth Minder
- Swiss Reference Centre for Porphyrias, Municipal Hospital Zurich Triemli, 8063 Zurich, Switzerland
- Division for Endocrinology, Diabetology and Porphyria, Municipal Hospital Zurich Triemli, 8063 Zurich, Switzerland
| | - Francesca Granata
- International Porphyria Patient Network (IPPN), 8032 Zurich, Switzerland
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, S.C Medicine and Metabolic Disorders, 20122 Milano, Italy
| | - Mårten Pettersson
- International Porphyria Patient Network (IPPN), 8032 Zurich, Switzerland
| | - Cornelia Dechant
- International Porphyria Patient Network (IPPN), 8032 Zurich, Switzerland
| | | | - Rocco Falchetto
- International Porphyria Patient Network (IPPN), 8032 Zurich, Switzerland
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Muschalek W, Hermasch MA, Poblete-Gutiérrez P, Frank J. The Porphyrias. J Dtsch Dermatol Ges 2022; 20:316-331. [PMID: 35304965 DOI: 10.1111/ddg.14743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/16/2022] [Indexed: 12/01/2022]
Abstract
The porphyrias are clinically variable and genetically heterogeneous, predominantly hereditary metabolic diseases, which are caused by a dysfunction of specific enzymes in heme biosynthesis. Here, we provide an overview of the etiopathogenesis, clinic, differential diagnosis, laboratory diagnostics and therapy of these complex metabolic disorders and cover in detail the most common form of porphyria worldwide (porphyria cutanea tarda), the most frequent childhood porphyria (erythropoietic protoporphyria), and the most common neurocutaneous porphyria (variegate porphyria).
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Affiliation(s)
- Wiebke Muschalek
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
| | - Matthias A Hermasch
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
| | | | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
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Muschalek W, Hermasch MA, Poblete-Gutiérrez P, Frank J. Die Porphyrien. J Dtsch Dermatol Ges 2022; 20:316-333. [PMID: 35304948 DOI: 10.1111/ddg.14743_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/16/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Wiebke Muschalek
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Matthias A Hermasch
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | | | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
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McGlacken-Byrne SM, Dann L, Murphy A, Moylett E. Pain, swelling and irritability in the sun: what is the diagnosis? Arch Dis Child Educ Pract Ed 2021; 106:102-106. [PMID: 31434640 DOI: 10.1136/archdischild-2019-317384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/30/2019] [Indexed: 11/03/2022]
Abstract
A 7-year-old boy presented with a 24-hour history of severe burning pain affecting both hands that had started within minutes of playing outdoors. His mother reported that he had been running his hands under cold water and shaking his hands and head to try and relieve the pain. On examination, there was swelling of his hands, eyelids and cheeks. His parents mentioned that his hands and face had 'swollen in the sun' every summer from the age of 2 years.A 3-year-old girl presented with a 2-day history of left upper limb swelling following a day of prolonged sun exposure. Examination revealed non-pitting oedema extending from her left shoulder to hand with no associated tenderness, erythema or rash. Her mother reported six previous episodes of irritability following sun exposure during which she would cry and flap her hands 'for hours'.Oral steroids and antihistamines were prescribed in both cases with little effect. Findings of routine baseline investigations were normal in both cases. A radiograph of the upper limb in the second patient disclosed nothing abnormal.
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Affiliation(s)
- Sinead Mary McGlacken-Byrne
- Department of Paediatrics, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Lisa Dann
- Department of Paediatrics, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Annette Murphy
- Department of Dermatology, Galway University Hospital, Galway, Ireland
| | - Edina Moylett
- Department of Paediatrics, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
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Barman-Aksözen J, Nydegger M, Schneider-Yin X, Minder AE. Increased phototoxic burn tolerance time and quality of life in patients with erythropoietic protoporphyria treated with afamelanotide - a three years observational study. Orphanet J Rare Dis 2020; 15:213. [PMID: 32811524 PMCID: PMC7437008 DOI: 10.1186/s13023-020-01505-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Erythropoietic protoporphyria (EPP) is an ultra-rare genetic disorder (prevalence 1:150`000) characterized by instant painful phototoxic burn reactions in skin exposed to visible light. Afamelanotide is the first clinically tested therapy effectively increasing the time EPP patients can spend in direct sunlight without developing symptoms and reducing the number and severity of phototoxic reactions. OBJECTIVES We report our data on real-world effectiveness of afamelanotide treatment in EPP and its phototoxic burn protection factor (PBPF). METHODS We analysed clinical data collected between 2016 and 2018 in the Swiss EPP cohort (n = 39) on maximum phototoxic burn tolerance time (PBTT), i.e., maximum time spent in sunlight without phototoxic reaction, severity of phototoxic reactions as assessed by an 11-point Likert-type visual analogue scale (VAS), with 0 being no pain and 10 being the worst possible pain, and Quality of Life (QoL), as assessed with an EPP-specific instrument. RESULTS Before treatment, the PBTT was median 10 min (IQR 5-20). Under treatment, PBTT increased to median 180 min (IQR 120-240). Individual PBPF increased 1.8- to 180-fold (full range, median 15). The pain severity of the worst phototoxic reaction before treatment was median 10 and under treatment median 6 (IQR 3-7). QoL at the end of the observation period in 2018 (with all the assessed patients under treatment) was 81.4% (IQR 69.4-93.4, n = 34). A 97.4% treatment adherence rate was observed. CONCLUSION Treatment of EPP patients with afamelanotide is highly effective under real-world conditions. We suggest PBTT as a clinical meaningful endpoint in further clinical trials.
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Affiliation(s)
| | - Michèle Nydegger
- Institute of Anesthesia and Intensive Medicine, Stadtspital Waid und Triemli, Zurich, Switzerland
| | - Xiaoye Schneider-Yin
- Institute of Laboratory Medicine, Stadtspital Waid und Triemli, Zurich, Switzerland
| | - Anna-Elisabeth Minder
- Department for Endocrinology, Diabetology, Porphyria, Stadtspital Waid und Triemli, Zurich, Switzerland.
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Dickey A. Pitfalls and proposed solutions for patient communication about erythropoietic protoporphyria: A survey of parents and adult patients. J Am Acad Dermatol 2019; 81:1204-1207. [PMID: 30978424 DOI: 10.1016/j.jaad.2019.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/14/2019] [Accepted: 04/07/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Amy Dickey
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
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Kiberd J, Finlayson L. Delayed photosensitivity in a child with erythropoietic protoporphyria : a case report. SAGE Open Med Case Rep 2018; 6:2050313X18772125. [PMID: 29854403 PMCID: PMC5971381 DOI: 10.1177/2050313x18772125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Erythropoietic protoporphyria (EPP) is a genetically inherited disease that causes protoporphyrin accumulation in erythrocytes, skin, liver, bile, and stool. Clinically this manifests as photosensitivity with painful, edematous cutaneous porphyria. We present the case of a four-year-old boy with a delayed photosensitivity reaction to sunlight. In the evening following sun exposure, he would develop swelling and a violaceous rash on the dorsal surface of his hands and occasionally the helix of his ears. His reactions were severe, requiring morphine on more than one occasion prior to diagnosis. He later developed waxy depressed scars on his nose and cheeks. On laboratory investigation, both total and free protoporphyrin were elevated. Photosensitivity in EPP usually occurs minutes after sun exposure, but our patient had significantly delayed reactions. Genetic testing revealed mutation in the FECH gene that confirmed the diagnosis of EPP. Although rare, presentations of photosensitivity in the pediatric population should be carefully evaluated.
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Affiliation(s)
- James Kiberd
- Dalhousie University, Halifax Regional Municipality, Canada
| | - Laura Finlayson
- Dalhousie University, Halifax Regional Municipality, Canada.,Centre for Clinical Research, Queen Elizabeth II Health Sciences Centre, Halifax Regional Municipality, Canada
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Kürten V, Neumann NJ, Frank J. [Diagnosis of the porphyrias : From A (as in aminolevulinic acid) to Z (as in zinc protoporphyrin)]. Hautarzt 2016; 67:201-6. [PMID: 26743052 DOI: 10.1007/s00105-015-3741-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The porphyrias comprise a clinically, biochemically, and genetically heterogeneous group of predominantly hereditary metabolic disorders resulting from a dysfunction along the heme biosynthetic pathway. Whereas most variants can manifest with different cutaneous symptoms, some types only reveal life-threatening acute neurovisceral attacks. Therefore, interdisciplinary care of these patients is advisable. In this article, we provide an overview of characteristic clinical and laboratory findings in the various forms of porphyria and a diagnostic algorithm.
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Affiliation(s)
- V Kürten
- Hautklinik und Europäisches Porphyriezentrum, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - N J Neumann
- Hautklinik und Europäisches Porphyriezentrum, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - J Frank
- Hautklinik und Europäisches Porphyriezentrum, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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de Bataille S, Dutartre H, Puy H, Deybach JC, Gouya L, Raffray E, Pithon M, Stalder JF, Nguyen JM, Barbarot S. Influence of meteorological data on sun tolerance in patients with erythropoietic protoporphyria in France. Br J Dermatol 2016; 175:768-75. [PMID: 27030101 DOI: 10.1111/bjd.14600] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Erythropoietic protoporphyria (EPP) is a rare metabolic disorder, characterized by photosensitivity, caused by errors of the haem biosynthetic pathway. Avoidance of sun exposure is recommended; however, some patients suggested a paradoxical improvement of symptoms when they move to sunny areas. OBJECTIVES In a national French study, we sought to investigate the influence of sun exposure on EPP symptoms. MATERIALS AND METHODS We used a national transversal observational study by questionnaire. Patients were selected from the national record of the Centre Français des Porphyries (French Porphyrias referral centre). Sun exposure level by geographic area was assessed using climate data provided by the French national meteorological service (Météo France). RESULTS Eighty-nine patients were included. We notably observed that 40% of patients declared an improvement in their tolerance of sun exposure after repeated sun exposures. In the more sunny areas, the intensity of the pain was lower (r = -0·26) and the duration of the sun exposure responsible for flares was longer (r = 0·39) than in the areas that were less sunny (P < 0·05). CONCLUSIONS This study proposes a benefit of natural progressive sun exposure for patients with EPP.
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Affiliation(s)
- S de Bataille
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093, Nantes Cedex 1, France
| | - H Dutartre
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093, Nantes Cedex 1, France
| | - H Puy
- Centre Français des Porphyries, Hôpital Louis-Mourier Assistance Publique Hôpitaux de Paris, Colombes, France.,INSERM U1149, Centre de Recherche sur l'inflammation, 16 rue Henri Huchard, 75018, Paris, France.,Laboratory of Excellence, GR-Ex, Paris, France
| | - J-C Deybach
- Centre Français des Porphyries, Hôpital Louis-Mourier Assistance Publique Hôpitaux de Paris, Colombes, France
| | - L Gouya
- Centre Français des Porphyries, Hôpital Louis-Mourier Assistance Publique Hôpitaux de Paris, Colombes, France.,INSERM U1149, Centre de Recherche sur l'inflammation, 16 rue Henri Huchard, 75018, Paris, France.,Laboratory of Excellence, GR-Ex, Paris, France
| | - E Raffray
- Department of Biostatistics, CHU Nantes, Nantes, France
| | - M Pithon
- French national meteorological service, Météo France, Toulouse, France
| | - J-F Stalder
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093, Nantes Cedex 1, France
| | - J-M Nguyen
- Department of Biostatistics, CHU Nantes, Nantes, France
| | - S Barbarot
- Department of Dermatology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093, Nantes Cedex 1, France.
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Abstract
Photosensitivity is the clinical hallmark of both erythropoietic protoporphyria (EPP) and X-linked dominant protoporphyria (XLDPP). Both disorders result from a hereditary dysfunction in heme biosynthesis. Disease onset is usually in early childhood. However, rare patients with late-onset EPP in association with a myeloproliferative disorder or myelodysplastic syndrome have been reported. In this issue, Livideanu et al. describe the first patient with late-onset XLDPP.
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13
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Wahlin S, Marschall HU, Fischler B. Maternal and fetal outcome in Swedish women with erythropoietic protoporphyria. Br J Dermatol 2013; 168:1311-5. [PMID: 23738640 DOI: 10.1111/bjd.12242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Painful photosensitivity is characteristic of erythropoietic protoporphyria (EPP). In women, symptoms may be affected by menstrual cycle and pregnancy but very little is known about maternal and fetal outcome. OBJECTIVES To investigate the impact of menstruation, pregnancy and breast-feeding on photosensitivity and possible effects of EPP on maternal, fetal and neonatal outcome. METHODS Retrospective study screening all 20 Swedish women alive and older than 18 years diagnosed with EPP with a total of 33 deliveries. Data were retrieved for 19 women and 32 deliveries in medical records and completed by a questionnaire sent to the patients. RESULTS Photosensitivity worsened in five of 19 (26%) women around menstruation whereas amelioration was reported in 17 of 32 (53%) pregnancies and during 11 of 32 (34%) breast-feeding periods. Fertility rate was normal and there were no maternal or fetal complications apart from minor arterial hypertension in one woman. CONCLUSIONS The study confirms changes in photosensitivity during menstruation and pregnancy. Amelioration during breast-feeding is a new finding. Pregnancy appears safe without increased risks of pregnancy complications or adverse effects on fetal or neonatal health.
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Affiliation(s)
- S Wahlin
- Department of Gastroenterology and Hepatology, K63, Karolinska Institutet, Karolinska University Hospital, Huddinge, SE-141 86, Stockholm, Sweden.
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Frank J, Poblete-Gutiérrez P. Delayed diagnosis and diminished quality of life in erythropoietic protoporphyria: results of a cross-sectional study in Sweden. J Intern Med 2011; 269:270-4. [PMID: 21332583 DOI: 10.1111/j.1365-2796.2010.02283.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Photosensitivity testing in children. J Am Acad Dermatol 2010; 63:1019-25. [DOI: 10.1016/j.jaad.2009.12.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 12/12/2009] [Accepted: 12/13/2009] [Indexed: 11/22/2022]
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16
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Michaels BD, Del Rosso JQ, Mobini N, Michaels JR. Erythropoietic protoporphyria: a case report and literature review. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2010; 3:44-48. [PMID: 20725556 PMCID: PMC2921755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Erythropoietic protoporphyria is considered a rare disease overall, but in children is the most common form of porphyria, and certainly the most common type of erythropoietic porphyria. Despite this fact, erythropoietic protoporphyria is a disease that has been known to evade or at least delay diagnosis, leading to unnecessary suffering by the patient. Given the distress it may cause a patient and his or her family as well as the potential complications of this disease, the importance of maintaining a heightened awareness when presented with a child complaining of photosensitivity cannot be overstated. This case report will review the important clinical indicators, pathogenesis, histology, diagnosis, management, and treatment of this disease, so that affected children will no longer have to play "hide and seek" when diagnosed with this sun-sensitive disease.
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Affiliation(s)
- Brent D. Michaels
- Dermatology Resident (PGY-2), Valley Hospital Medical Center, Las Vegas, Nevada
| | - James Q. Del Rosso
- Dermatology Residency Director, Valley Hospital Medical Center, Las Vegas, Nevada, and Director of Dermatology Research, Mohave Skin & Cancer Clinics, Las Vegas, Nevada
| | - Narciss Mobini
- University of Nevada School of Medicine, Las Vegas, Nevada
| | - Jason R. Michaels
- Clinical Instructor (Dermatology), Valley Hospital Medical Center, Las Vegas, Nevada
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Wu X, Pan L, Wang Z, Liu X, Zhao D, Zhang X, Rupp RA, Xu J. Ultraviolet irradiation induces autofluorescence enhancement via production of reactive oxygen species and photodecomposition in erythrocytes. Biochem Biophys Res Commun 2010; 396:999-1005. [DOI: 10.1016/j.bbrc.2010.05.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 05/10/2010] [Indexed: 12/01/2022]
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Vogeser M, Müller W, Stauch T. Inter-laboratory survey of erythrocyte free protoporphyrin quantification - announcement of a pilot study. Clin Chem Lab Med 2008; 46:1340-1. [PMID: 18785875 DOI: 10.1515/cclm.2008.268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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