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The diagnosis of acute intermittent porphyria combined with seizures: Case report
Zhen Wang1, Liniu Cheng, Xianyang Liang
1Department of Neurology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China.
Rationale:
Acute intermittent porphyria (AIP) is a rare metabolic disorder affecting heme production due to enzyme porphobilinogen deaminase deficiency. Diagnosing acute intermittent porphyria is difficult because its symptoms interrelate with those of other common diseases. When AIP is combined with seizures, the diagnosis process is more complicated. This case report shows all tests and criteria used to arrive at the final stage of diagnosis.
Patient Concerns:
The patient complained of severe abdominal pain, nausea, vomiting, and intermittent convulsions. Her medical history shows she had abdominal pain, mainly dull pain in the left upper abdomen.
Diagnoses:
Different symptomatic tests were done, and the cause of her symptoms was uncertain. A urine sun drying test was then done and confirmed the presence of porphyrin used to diagnose AIP. A genetic test was done after the patient was discharged, and AIP diagnosis was confirmed.
Interventions:
Acute intermittent porphyria treatment was administered.
Outcomes:
The patent recovered fully.
Lessons:
It is essential to consider acute intermittent porphyria diagnosis in patients having unexplained severe abdominal pain associated with neurological and psychiatric symptoms. Since AIP is a rare disease with a high mortality rate when not treated early, Clinical practices should include AIP as one of the tests done on patients showing these symptoms at an early stage. The fastest way to identify this is to conduct a urine test. The change of color from brown to reddish color is a diagnostic indicator of AIP. This strategy helps reduce misdiagnoses and delayed treatment of the right disease.
Insights
Diagnosing acute intermittent porphyria (AIP) can be challenging due to overlapping symptoms. A urine test confirming porphyrin presence, followed by genetic testing, successfully diagnosed AIP in a patient with severe abdominal pain and seizures.
Area of Science:
- Biochemistry
- Genetics
- Internal Medicine
Background:
- Acute intermittent porphyria (AIP) is a rare metabolic disorder impacting heme synthesis, caused by porphobilinogen deaminase deficiency.
- AIP diagnosis is often delayed due to symptom overlap with common diseases, particularly when seizures are present.
- This case report details the diagnostic process for AIP in a patient presenting with complex symptoms.
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