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Variegate Porphyria Triggered by Acute Hepatitis A Infection.

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European Journal of Case Reports in Internal Medicine
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Hepatitis A infection can trigger latent variegate porphyria (VP), a rare metabolic disorder. This case highlights the importance of suspecting acute cutaneous porphyria in patients with photosensitive rashes and abdominal pain.

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Area of Science:

  • Biochemistry
  • Hepatology
  • Dermatology

Background:

  • Variegate porphyria (VP) is a rare genetic disorder affecting heme biosynthesis.
  • Hepatitis A infection is a common viral illness.

Purpose of the Study:

  • To report a novel association between acute hepatitis A infection and the overt presentation of latent variegate porphyria.
  • To emphasize the role of metabolic stress in unmasking latent genetic disorders.

Main Methods:

  • Case report of a 31-year-old male diagnosed with acute hepatitis A.
  • Clinical presentation included abdominal pain and a photoaggravated blistering skin eruption during recovery.
  • Biochemical analysis of urine and fecal porphyrins, and plasma fluorescence emission.

Main Results:

  • Markedly elevated urine porphyrin precursors and high coproporphyrin III isomer levels.
  • Markedly increased fecal protoporphyrin levels and characteristic plasma fluorescence.
  • Diagnosis of VP confirmed during acute hepatitis A infection.

Conclusions:

  • Acute hepatitis A infection can act as a trigger for overt manifestation of latent VP.
  • Metabolic stress on the heme biosynthetic pathway can induce symptoms of VP.
  • High index of suspicion for acute cutaneous porphyria is warranted in patients with photosensitive rash and neurovisceral symptoms.