Yoshida A, Hagiwara S, Watanabe T, Nishida N, Ida H, Sakurai T, Komeda Y, Yamao K, Takenaka M, Enoki E, Kimura M, Miyake M, Kawada A, Kudo M. Erythropoietic Protoporphyria-related Hepatopathy Successfully Treated with Phlebotomy.
Intern Med 2018;
57:2505-2509. [PMID:
30175727 PMCID:
PMC6172546 DOI:
10.2169/internalmedicine.0673-17]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 27-year-old man bearing an erythropoietic protoporphyria (EPP)-associated ferrochelatase (FECH) mutation was admitted to our hospital for general malaise and marked elevation of the serum levels of hepatobiliary enzymes and bilirubin. Initial treatment with plasma exchange did not reduce the blood protoporphyrin or serum liver enzyme levels, so phlebotomy was started. Surprisingly, weekly phlebotomy normalized the serum levels of liver enzymes, accompanied by a marked reduction in the blood protoporphyrin levels. The clinical course of this case strongly suggests that phlebotomy may be a suitable treatment option for EPP-related hepatopathy.
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