Chloroquine in the Treatment of Porphyria Cutanea Tarda

Environmental Chemical Exposures and Disturbances of Heme Synthesis

“…In VP, one small case series reported the lowest values of urine ALA, PBG, uroporphyrin, and coproporphyrin in acute attacks to be 9, 12, 190, and 27 times the mean control values, respectively (26), which was consistent with the higher average values reported in a larger series (27). In reports of the cutaneous porphyrias, urine uroporphyrin in PCT increased to about 10 to 375 times normal in over 300 reported cases (except in one case (59), where a single value was within normal range) (60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70), and in EPP, reported erythrocyte protoporphyrin values ranged from 2.4 to Environmental Health Perspectives * Vol 105, Supplement 1 * February 1997 90 times normal (31,65,71), with the exception of a single patient in whom it was elevated by only a factor of 1.4 (31). Finally, in reports of the less common (autosomal-recessive) cutaneous porphyrias, urine porphyrins in CEP were 20 to 60 times normal (7) (96)(97)(98).…”

Environmental chemical exposures and disturbances of heme synthesis.

“…In VP, one small case series reported the lowest values of urine ALA, PBG, uroporphyrin, and coproporphyrin in acute attacks to be 9,12,190, and 27 times the mean control values, respectively (26), which was consistent with the higher average values reported in a larger series (27). In reports of the cutaneous porphyrias, urine uroporphyrin in PCT increased to about 10 to 375 times normal in over 300 reported cases (except in one case (59), where a single value was within normal range) (60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70) (31,65,71), with the exception of a single patient in whom it was elevated by only a factor of 1.4 (31). Finally, in reports of the less common (autosomal-recessive) cutaneous porphyrias, urine porphyrins in CEP were 20 to 60 times normal (7) and in HEP, urine uroporphyrin increased by at least 20-fold and erythrocyte porphyrins increased by 5-to 10-fold (28,29,72).…”

Relapse of porphyria cutanea tarda after treatment with phlebotomy or 4-aminoquinoline antimalarials: a meta-analysis

“…Twelve studies that evaluated treatment of 525 PCT patients by phlebotomy, 4-aminoquinolines (using a low dose regimen, defined as twice weekly use of chloroquine 125 mg or hydroxychloroquine 100 mg, a high dose regimen defined as using higher doses, or both phlebotomy and a 4-aminoquinoline were included in the analysis. (11; 24; 25; 26; 27; 28; 29; 30; 31; 32; 33; 34) Studies were stratified into three categories based on the treatment regimen; the first group was treated with high dose 4-aminoquinoline regimens, (11; 24; 25; 26; 27) the second one with low dose regimens (28; 29; 30; 31; 32) and the third underwent repeated phlebotomies. (32; 33; 34) Data about specific dosages, phlebotomy schedules and duration of therapy are provided in (Table 1).…”