Summary. Acute intermittent porphyria (AIP) is a rare metabolic disorder that is characterized by partial deficiency of the enzyme hydroxymethylbilane synthase (also known as porphobilinogen deaminase). This enzyme deficiency can result in the accumulation of porphyrin precursors in the body.

What are the symptoms of AIP?

• Psychological symptoms such as feeling anxious, confused, or depressed.
• Muscle weakness.
• Fast heart rate.
• Pain in the arms, legs, chest, neck, or head.
• High blood pressure.
• Nausea or vomiting.
• Pain in the abdomen.
• Constipation.

Is there a cure for AIP?

AIP is a rare inherited disease that can cause serious symptoms that affect your body, such as your brain and nervous system. The most common symptom is severe abdominal pain. There is no cure for AIP, but it can be managed.

What triggers AIP?

, or using illegal drugs such as amphetamines or cocaine may trigger AIP attacks. Stress on the body caused by infections, illness, or surgery may trigger AIP attacks. AIP is caused by a partial lack of an enzyme that the body needs.

Is acute intermittent porphyria fatal?

Acute neurovisceral attacks of porphyria can be life threatening. They are rare and notoriously difficult to diagnose clinically, but should be considered, particularly in female patients with unexplained abdominal pain, and associated neurological or psychiatric features or hyponatraemia.

What foods should be avoided with porphyria?

People with porphyria are advised to maintain a diet with an average or higher-than-average intake of carbohydrates, which can lessen disease activity—but they are also advised to avoid refined sugars, corn syrup and heavily processed foods.

How common is AIP?

Increased urine PBG excretion in a known AIP patient is therefore not necessarily diagnostic of an acute attack. Affected Populations: The exact incidence and prevalence of symptomatic AIP is unknown. In Europe the prevalence is estimated to be approximately 5.9 per million people in the general population.

What makes urine red in acute intermittent porphyria?

Diagnosis of Acute Intermittent Porphyria Levels of these precursors are very high during attacks and remain high in people who have repeated attacks. The precursors can form porphyrins, which are reddish. These porphyrins turn the urine red to red-brown.

What does porphyria pain feel like?

Chronic pain experienced between attacks was often characterized as sore, dull, aching, throbbing, and/or burning (Table 2) and was the most frequently reported chronic symptom, experienced by 17 patients (78%).

Why there is abdominal pain in acute intermittent porphyria?

Abdominal pain is by far the most serious symptom in attacks of acute intermittent porphyria. Its cause is unknown. This case study suggests visceral ischaemia as a possible cause of the abdominal pain.

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What triggers porphyria?

Porphyria can be triggered by drugs (barbiturates, tranquilizers, birth control pills, sedatives), chemicals, fasting, smoking, drinking alcohol, infections, emotional and physical stress, menstrual hormones, and exposure to the sun. Attacks of porphyria can develop over hours or days and last for days or weeks.

Is acute intermittent porphyria inherited?

How is acute intermittent porphyria (AIP) inherited? AIP is inherited in an autosomal dominant fashion, which means only one of the two HMBS genes needs to have a disease-causing mutation to decrease enzyme activity and cause symptoms.

Is acute hepatic porphyria a rare disease?

A rare sub-group of porphyrias characterized by the occurrence of neuro-visceral attacks with or without cutaneous manifestations.

What is the life expectancy of someone with porphyria?

Patients with porphyria generally have a normal life expectancy. However, those with acute hepatic porphyria are at increased risk of developing high blood pressure, chronic kidney disease, and hepatocellular carcinoma (liver cancer), which may reduce their lifespan.

Can porphyria be cured?

Although porphyria can’t be cured, certain lifestyle changes to avoid triggering symptoms may help you manage it. Treatment for symptoms depends on the type of porphyria you have.

Can porphyria cause weight gain?

“Unfortunately, because of the therapeutic high carbohydrate intake, patients with hepatic porphyrias are prone to weight gain. Losing excess weight is very difficult for some of these patients because of fasting-induced acute attacks.

What part of the body does porphyria affect?

Porphyria occurs when the body cannot convert compounds called ‘porphyrins’ into heme. While all tissues have heme, those that use it the most are the red blood cells, liver and bone marrow. Porphyria can affect the skin, nervous system and gastrointestinal system. More women than men are affected by porphyria.

How do you test for porphyria?

To diagnose porphyrias, laboratories measure porphyrins and their precursors in urine, blood, and/or stool. Testing may include measurement of one or more of the following: Porphobilinogen (PBG), a porphyrin precursor, in urine. Delta-aminolevulinic acid (ALA), another porphyrin precursor, in urine.

Does porphyria cause fatigue?

The most common symptoms associated with such attacks were pain, nausea, and vomiting. Chronic symptoms described included pain, nausea, fatigue, and aspects of neuropathy like tingling and numbness.

Does porphyria cause joint pain?

People who have acute porphyrias commonly suffer fatigue. This may be due to symptoms affecting muscles and joints (such as pain, numbness and weakness) and the sleep disturbance this may cause. In some cases the effects of medication used to control symptoms may contribute to bouts of tiredness.

Can you take ibuprofen with porphyria?

Aspirin, ibuprofen, indomethacin, ketoprofen, flurbiprofen, phenylbutazone, naproxen, prednisolone, and penicillamine did not increase ALA synthase activity and should be safe in porphyria.

What genetic mutation causes porphyria?

Mutations in the UROD gene cause familial porphyria cutanea tarda (PCT), a rarer subtype of PCT, which is the most common form of porphyria. These mutations result in the lack of uroporphyrinogen decarboxylase, the next enzyme in the heme pathway.

When should you suspect porphyria?

The diagnosis of acute porphyria should be suspected, especially in women who present symptoms linked to their menstrual cycles more than once in the ED. Once suspected, the diagnosis of porphyria can be rapidly established by measuring urinary PBG.

Can porphyria go into remission?

With treatment, most people go into remission, meaning they don’t have symptoms after their skin is exposed to sunlight and their porphyrin levels return to normal. To help people go into and stay in remission, doctors also recommend avoiding or eliminating factors that can cause porphyria cutanea tarda.

How can porphyria be prevented?

1. Not using medications known to trigger acute attacks. …
2. Not using alcohol or recreational drugs.
3. Avoiding fasting and dieting that involves severe calorie restriction.
4. Not smoking.
5. Taking certain hormones to prevent premenstrual attacks.
6. Minimizing sun exposure.

Can people with porphyria have kids?

Almost without exception, female patients with porphyria (of any sort) have normal pregnancies and deliver healthy babies without experiencing acute attacks. However, pregnancy is associated with increased levels of hormones such as progesterone which potentially may aggravate porphyria.

What does acute hepatic porphyria mean?

Acute Hepatic Porphyria (AHP) refers to a family of rare genetic diseases characterized by potentially life-threatening attacks and, for some people, chronic (ongoing and sometimes lifelong) pain and other symptoms that interfere in their ability to live normal lives.