Porphyria

Stanley Binagi

Definition

• Porphyria refers to a group of disorders that result in a build-up of chemicals called porphyrins in your body.

• Although porphyrins are normal body chemicals, it's not normal for them to build up. The cause is usually an inherited mutation.

• Porphyria typically affects your nervous system or skin or both. • Porphyria is usually inherited, but environmental factors may

trigger the development of symptoms in some types of porphyria.

• Although porphyria usually can't be cured, certain lifestyle changes may help you manage porphyria.

Cause

• One cause, two ways:• Autosomal dominant inheritance pattern• Autosomal recessive inheritance pattern

• The main cause is, the presence of an inherited mutation in one of the genes involved in heme production, which can cause an enzyme deficiency, which can lead to porphyrins building up in your body.

• NB: Porphyrins are supposed to be converted into heme. This process requires 8 enzymes.

Types

• There are two main categories of Porphyria, Acute and Cutaneous.

• Acute porphyrias forms of the disease that cause predominantly NS symptoms and, in some cases, skin symptoms, as well.

• Cutaneous porphyrias include forms of the disease that cause skin symptoms as a result of oversensitivity to sunlight, but don't affect your nervous system

Signs and Symptoms

• CUTANEOUS PORPHYRIA:• Itching• Erthema• Skin swelling• Blisters• Red urine

Signs and Symptoms

• ACUTE PORPHYRIA:Insomnia Excessive sweating

Anxiety Seizures

Severe abdominal pain Confusion

Constipation Hallucination

Vomiting Disorientation

Diarrhoea Hypertension

Pain in arms/legs/back Red urine

Dehydration e.t.c

Treatment

• Acute porphyrias Treatment of acute porphyrias focuses on eliminating symptoms

• Stopping medication which may trigger it• Drugs to controll pain• Treatment of other associated diseases• Give IV glucose to maintain carbohydrate intake.• IV fluids to prevent dehydration• Hemin or hematin injections.

Treatment

• Cutaneous porphyrias Treatment of cutaneous porphyrias focuses on reducing the amount of porphyrins in your body to help eliminate your symptoms.

• Drawing blood (phlebotomy). This reduces the iron in your body, which decreases porphyrins• Medication. Drugs used to treat malaria — such as hydroxychloroquine and chloroquine — can absorb excess porphyrins and help your body get rid of them• Beta carotene. Daily doses of beta carotene or other carotenoids, such as canthaxanthin may increase your skin's tolerance to sunlight.

Reference

• Mayo Clinic articles