Case 20-2008

Bonkovsky, Herbert L.; Siao, Peter; Roig, Zulmarie; Hedley‐Whyte, E. Tessa; Flotte, Thomas J.

doi:10.1056/nejmcpc0803190

Cited by 37 publications

(12 citation statements)

References 21 publications

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“…Acute intermittent porphyria after surgery is very rare with only few case reports in the literature [9], [10], [11], [12], [13]. We present what we believe is the first case of AIP after right hemi-colectomy.…”

Section: Introductionmentioning

confidence: 79%

“…Most likely, her attack of AIP was precipitated by a combination of (1) hormonal changes during menstruation, (2) epidural analgesia of lidocaine and fentanyl, (3) low-calorie intake during the postoperative period (510 Kcal/day) and (4) surgical site pain after cessation of epidural analgesia [1], [11]. Medline search revealed only five cases of AIP after surgery (Table 1) [9], [10], [11], [12], [13]. Other triggers that increase the demand for heme and hence induce AIP include porphyrinogenic drugs, infections, smoking, alcohol intake, fasting, psychological stress, and hormonal changes associated with menstruation and ovulation [1], [2], [3].…”

Section: Discussionmentioning

confidence: 99%

“…Medline search revealed only five cases of AIP after surgery (Table 1) [9], [10], [11], [12], [13]. Other triggers that increase the demand for heme and hence induce AIP include porphyrinogenic drugs, infections, smoking, alcohol intake, fasting, psychological stress, and hormonal changes associated with menstruation and ovulation [1], [2], [3].…”

Section: Discussionmentioning

confidence: 99%

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Acute intermittent porphyria after right hemi-colectomy

Alshammary

Dulaijan

Saleh

et al. 2017

International Journal of Surgery Case Reports

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HighlightsAcute intermittent porphyria is rare.High index of suspicion is needed to diagnose acute intermittent porphyria in a patient with abdominal pain, neuro-psychiatric manifestations and hyponatremia after surgery.Once suspected, prompt intensive care management should include high calorie intake, symptomatic treatment of hyponatremia, use of safe medications and careful fluid-electrolyte monitoring in order to avoid serious complications and mortality.

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Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute intermittent porphyria after right hemi-colectomy

Alshammary

Dulaijan

Saleh

et al. 2017

International Journal of Surgery Case Reports

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“…The porphyrias are a rare group of medical conditions characterised by abnormalities in the haem biosynthetic pathway [1]. Most cases are inherited (e.g.…”

Section: Discussionmentioning

confidence: 99%

A Case of Variegate Porphyria in Association With Coeliac Disease and Bisphosphonate Associated Dental Osteonecrosis

Ogundipe

2009

J Clin Med Res

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This case describes an older patient with a rare diagnosis of variegate porphyria presenting with acute abdominal pains and bloating, intermittent loose stools and jaw pains following surgical repair of an osteoporotic hip fracture. She was noted to have acute hyponatraemia. All the abdominal symptoms and the hyponatraemia were initially attributed to an acute episode of variegate porphyria with an accompanying syndrome of inappropriate antidiuretic hormone secretion. However, following further evaluations necessitated by the incomplete resolution of the abdominal symptoms, it became apparent that some of the persisting symptoms were due to a concurrent and new presentation of serology positive coeliac disease. The jaw pains were established to be due to dental osteonecrosis in association with the use of bisphosphonate therapy for treatment of osteoporosis. The various symptoms and signs subsequently settled uneventfully following institution of appropriate management options for the various coexisting diagnoses.KeywordsAbdominal pain; Abdominal bloating; Loose stools; Hyponatraemia; Variegate porphyria; Coeliac disease; Osteoporosis; Bisphosphonates; Osteonecrosis

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“…91 (2) Attacks are also provoked by reduced calorie intake (as in crash dieting to lose weight), infections, and major surgery. 92,93 As already noted, induction of hepatic ALAS1 by fasting is mediated by PGC-1α, now recognized as an important link between nutritional status and acute porphyrias. 59 (3) Female sex and symptoms occurring during the luteal phase of the menstrual cycle may suggest the diagnosis.…”

Section: A Clinical Features and Indications For Testingmentioning

confidence: 91%

Clinical and Laboratory Diagnosis of the Porphyrias

Anderson

2013

Handbook of Porphyrin Science (Volume 29)

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Case 20-2008

Cited by 37 publications

References 21 publications

Acute intermittent porphyria after right hemi-colectomy

Acute intermittent porphyria after right hemi-colectomy

A Case of Variegate Porphyria in Association With Coeliac Disease and Bisphosphonate Associated Dental Osteonecrosis

Clinical and Laboratory Diagnosis of the Porphyrias

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