Porphyria and chemicals

Porphyria is a genetic family of diseases that is most frequently described as neuropsychiatric or toxogenetic. It is well known to be initiated by drugs, infections, heavy metals, hormones, chemicals and fasting. There are extensive lists of drugs that have been known to cause attacks. Others are thought to be likely to cause attacks on the basis of animal studies or in vitro studies. It has become obvious that lists of chemicals capable of causing illness in porphyrics are sorely lacking. Chemicals that have the same base as drugs that are labeled in the PDR (Physicians Desk Reference) as porphyrogenic have no such labeling in their MSDS (Material Safety Data Sheet). This article is intended to point out why porphyria needs to be considered when illness occurs after chemical exposure. The capability of testing enzymes in the porphyrin pathway allows us to evaluate these patients more thoroughly, for we are now aware that the standard measures for recognizing these diseases are often inadequate. Three examples where illness has occurred after environmental exposure to chemicals will serve as illustrations. One, a documented porphyria, is the Turkish porphyria. The other two are not yet documented as porphyria, but may be some day. One is Agent Orange which caused illness in Vietnam, and the other is exposure to unknown sources of what has been named the Gulf War syndrome.