Desferrioxamine treatment of porphyria cutanea tarda in a patient with HIV and chronic renal failure

Vasconcelos, Pedro; Luz-Rodrigues, Henrique; Santos, Carlos Pereira dos; Filipe, Paulo

doi:10.1111/dth.12024

Cited by 9 publications

(8 citation statements)

References 3 publications

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“…Several abnormalities of porphyrin metabolism leading to PCT have been described in patients who reached ESRD (Figure 2 A). The prevalence of acquired PCT in haemodialysis ranges from 5 to 18% [ 21 , 22 ], although systematic studies have not been performed. Notably, the levels of uroporphyrins in unaffected ESRD patients can be similar to or exceed (due to the lack of renal clearance) the levels found in patients who have PCT and normal kidney function, suggesting that additional precipitating factors likely occur [ 23 ].…”

Section: Esrd Predisposes To Porphyriamentioning

confidence: 99%

Porphyria and kidney diseases

Pallet

Karras

Thervet

et al. 2018

Clinical Kidney Journal

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The kidneys, after the bone marrow and liver, are third in terms of the amounts of haem synthesized daily. Haem is incorporated into haemoproteins that are critical to renal physiology. In turn, disturbances in haem metabolism interfere with renal physiology and are tightly interrelated with kidney diseases. Acute intermittent porphyria causes kidney injury, whereas medical situations associated with end-stage renal disease, such as porphyrin accumulation, iron overload and hepatitis C, participate in the inhibition of uroporphyrinogen decarboxylase and predispose the individual to porphyria cutanea tarda. Even if some of these interactions have been known for a long time, the clinical situations associated with these interrelations have strikingly evolved over time with the advent of new therapeutic strategies for dialysis therapy and a better understanding of the pathophysiological mechanisms of porphyria-associated kidney disease. Physicians should be aware of these interactions. The aim of this review is to summarize the complex interactions between kidney physiology and pathology in the settings of porphyria and to emphasize their often-underestimated importance.

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Section: Esrd Predisposes To Porphyriamentioning

confidence: 99%

Porphyria and kidney diseases

Pallet

Karras

Thervet

et al. 2018

Clinical Kidney Journal

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“…PCT, which is classified into sporadic and hereditary types, is also characterized by skin lesions in sun-exposed areas and liver dysfunction, as in EPP. A number of factors, such as alcohol ( 15 ), hepatitis C virus infection ( 16 ), HIV infection ( 16 , 17 ), estrogen exposure ( 18 ), renal failure ( 19 ), and lymphoma ( 20 ), have been identified as potential triggers for sporadic PCT. However, in contrast to EPP, PCT is characterized by iron overloading, which partially explains the liver dysfunction in this type of erythropoietic porphyria.…”

Section: Discussionmentioning

confidence: 99%

Erythropoietic Protoporphyria-related Hepatopathy Successfully Treated with Phlebotomy

et al. 2018

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A 27-year-old man bearing an erythropoietic protoporphyria (EPP)-associated ferrochelatase (FECH) mutation was admitted to our hospital for general malaise and marked elevation of the serum levels of hepatobiliary enzymes and bilirubin. Initial treatment with plasma exchange did not reduce the blood protoporphyrin or serum liver enzyme levels, so phlebotomy was started. Surprisingly, weekly phlebotomy normalized the serum levels of liver enzymes, accompanied by a marked reduction in the blood protoporphyrin levels. The clinical course of this case strongly suggests that phlebotomy may be a suitable treatment option for EPP-related hepatopathy.

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“…HIV infection is the cause of abnormal excretion of porphyrins, even with no clinical evidence of PCT. 1,9 …”

Section: Discussionmentioning

confidence: 99%

Porphyria cutanea tarda in a HIV- positive patient

Franzon

Mikilita

Camelo

et al. 2016

An. Bras. Dermatol.

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This is a case report about Porphyria cutanea tarda (PCT) and its relationship with the infection caused by the human immunodeficiency virus (HIV). Cutaneous porphyria is an illness caused by enzymatic modification that results in partial deficiency of uroporphyrinogen decarboxylase (Urod), which may be hereditary or acquired. Several studies suggest that HIV infection associated with cofactors might trigger the development of porphyria cutanea tarda. In this case report, we present a patient infected with HIV, who after the introduction of antiretroviral therapy (ART) enjoyed clinical improvement of porphyria cutanea tarda symptoms.

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Desferrioxamine treatment of porphyria cutanea tarda in a patient with HIV and chronic renal failure

Cited by 9 publications

References 3 publications

Porphyria and kidney diseases

Porphyria and kidney diseases

Erythropoietic Protoporphyria-related Hepatopathy Successfully Treated with Phlebotomy

Porphyria cutanea tarda in a HIV- positive patient

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