Porphyria Variegata

Variegate porphyria

Variegate porphyria is a rare, hereditary form of hepatic porphyria characterized by acute systemic symptoms as in acute intermittent porphyria in addition to cutaneous symptoms simulating porphyria cutanea tarda. We describe a 22-year-old female from India who first presented to the emergency department with acute symptoms and was later confirmed to have variegate porphyria.

[Inappropriate secretion of antidiuretic hormone disclosing acute intermittent porphyria]

The authors report a case of acute intermittent porphyria in a 31-year old woman, revealed by inappropriate secretion of the antidiuretic hormone, a diagnosis confirmed by radioimmunoassay. Measurements of red cell urosynthetase made the diagnosis of porphyria certain and showed that the disease was familial, although clinically asymptomatic. Antidiuresis is not the only cause of hyponatraemia in acute intermittent porphyria. Similarly, psychic disorders are frequent in SIADH, but they are not necessarily due to acute intermittent porphyria.

Microscopic abnormalities in the liver of two patients with Porphyria variegata

In contrast to Porphyria cutanea tarda (PCT), which is characterized by constant hepatic involvement, the liver seems to be unaltered in Porphyria variegata (PV). However, the authors have found microscopic alterations in the liver of 2 patients with PV (mild inflammation and fibrosis of the portal tracts and the presence of iron deposits in one of the cases). Although these changes could be attributed to other causes, the hypothesis of possible liver involvement in PV is not excluded.