Fatal Case of Acute Porphyria

Nonsurgical Abdominal Pain

“…The abdominal symptoms, according to Rentschler,5 are thought to be due to involvement of the sympathetic ganglia and vagal nuclei. Electrolyte studies, as shown by Linder 7 and Abrahams et al, 8 may show a marked lowering of the serum sodium and chloride but a normal carbon dioxide-combining power. The diagnosis depends on the porphobilinogen in the urine demonstrated by a simple test described by Watson and Schwartz.…”

“…The patient, a 40 year old white woman, gravida III, in the seventh month of pregnancy was admitted to the hospital on November 8,1951. Approximately two hours prior to admission she had had the sudden onset of severe, persistent upper abdominal pain associated with vomiting.…”

Sodium and Chloride Depletion in Acute Porphyria With Reference to the Status of Adrenal Cortical Function

“…The question of a parallel increase of desoxycorticosterone-like activity on the part of the adrenal under such conditions is not settled, but it is probable that the part played by the adrenal in the "alarm reaction" is mediated through the anterior pituitary (Selye [14], Long [15] (1). The adrenals of these cases may be compared with the adrenal cortex from a man with Cushing's syndrome excretion up to 8.2 mgm.…”

Porphyria Cutanea Tarda in Relapse: A Case Report

“…In our patient the low values for serum sodium and chloride persisted for several weeks. Although other workers (Abrahams, Gavey, and Maclagan, 1947) have shared the view that an adrenal cause for this is operative, evidence for a renal cause has also been afforded (Prunty, 1949). In this patient the results of tests do not suggest impaired adrenal function, which, if present, would have an obvious bearing on therapy.…”

“…In this patient the results of tests do not suggest impaired adrenal function, which, if present, would have an obvious bearing on therapy. It may be noted that both Linder (1947) and Abrahams et al (1947) produced only temporary success by the administration of salt and adrenocortical extract, while trials of A.C.T.H. or cortisone have been negative or at best inconclusive (Oltman and Friedman, 1951 ;Myerson, 1951 Gilbert, Toupin, andBell, 1951;Meyers and Griffith, 1952;Goldberg, MacDonald, and Rimington, 1952;Watson, 1952).…”