[Porphyrias, a rare cause of acute abdominal pain]

The porphyrias are uncommon disorders caused by deficiencies of some enzymes of the heme biosynthetic pathway. Only four hepatic porphyrias are able to cause acute abdominal syndrome. In any case, the diagnosis requires the demonstration of increased urinary or stool excretion of accumulated metabolites of heme synthesis. Treatment is now possible and is able to reduce the burden of these metabolic diseases. The management implies also the identification of trigger exogenous factors such as oral contraceptives.