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At least 19 recordsLinked to original sources
PubMed1977

[Cryomacroglobulinemic purpura with liver cirrhosis and hepatic porphyria].

Hepatic porphoria and histologically verified cirrhosis, teleangiectasia, purpose, papular skin lesions existing for eight years, as well as cryomacroglobulin were found in a 49 year old man. Pathogenetically the liver disease is considered to be the primary event, which was accompanied by secondary cryoglobulinemia. IgG and IgM type of thrombus in the vessels and of small granular deposits corresponding to the type of cryoprotein in the blood, were detected in the vessel walls of the upper part in the dermis and along these vessels of both purpuri and papular skin lesions. Immunoprecipitates could be revealed by FTC-labelled antihuman complement. In the skin lesions porphyrin could not be demonstrated. The investigation of cryoglobulin and of porphyrin disorders is reasonable in every patient with purpura accompanying pathological liver processes.

Cryoglobulins↗
PubMed1978

[The hepatic porphyrias].

Among the different types of hepatic porphyrias, acute intermittent porphyria (AIP) and the group of chronic hepatic porphyrias (CHP) are most frequently seen in Europe. Both diseases are supposed to be inherited, but clinical manifestation mostly occurs following endogenous and especially exogenous stimulation. While recurrent attacks of abdominal and neuropsychiatric symptoms in AIP are frequently precipitated by therapeutic doses of commonly used drugs, the gradual development of porphyria cutanea tarda (PCT) from a clinically non-apparent type of CHP seems to be most commonly due to excessive and prolonged intake of alcohol. The characteristic and with regard to the laboratory findings important pathobiochemical features, the clinical symptoms, and the present therapeutic concepts of both disorders of hepatic porphyrin metabolism are discussed. The prognosis of hepatic porphyrias will be determined above all by early diagnosis of the metabolic disorder as well as by a profound medical information of the patient to avoid strictly all well-known exogenous factors which may initiate or exacerbate the disease.

Adult↗
PubMed1977

Hepatic porphyrias. Current concepts.

Acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria are hepatic porphyrias due to enzyme defects that are inherited as autosomal dominants. Porphyria cutanea tarda is considered an acquired disorder. Similar drugs or circumstances are precipitants of acute attacks in all three inherited hepatic porphyrias. The respective biochemical abnormalities are identifiable by simple, readily available laboratory tests. Management of patients with any of the inherited hepatic porphyrias is directed primarily toward prevention of attacks through avoidance of precipitants and through a diet high in carbohydrate. Therapy for porphyria cutanea tarda includes interdiction of alcohol use and repeated phlebotomy.

5-Aminolevulinate Synthetase↗
PubMed1976

Hereditary hepatic porphyrias in Finland.

The occurrence of hepatic porphyrias--acute intermittent porphyria (AIP) and variegate porphyria (VP)--in Finland has been studied. During a period of 9 years 107 patients with AIP and 45 patients with VP were found. The prevalence of hereditary hepatic porphyrias was calculated to be 3.4 per 100 000 inhabitants. The patients belonged to 42 different families. Eighty-nine patients (59%) had had acute attacks, whereas 63 were symptomless latent cases. Precipitating factors, symptoms and excretion of porphyrins and their precursors did not significantly differ from what has been reported earlier from other parts of the world. A slight fragility of the skin on the back of the hands was noted in some 50% of VP patients. Abnormal sensitivity to sunlight could not be seen in a single case. However, about 50% of patients with VP showed an abnormal reaction when irradiated with artificial ultraviolet light. The difference in the skin symptoms in South African and Finnish VP patients is discussed.

Adolescent↗
PubMed1978

[Uroporphyrinogen decarboxylase in erythrocytes: studies on the primary genetic enzyme defect in chronic hepatic porphyria (author's transl)].

In chronic hepatic porphyria, including the clinical phase, porphyria cutanea tarda, the activity of uroporphyrinogen decarboxylase is decreased not only in the liver, but also in the erythrocytes. The synonomous decrease in the enzymic activity in liver and erythrocytes in both familial and sporadic hepatic porphyria shows that the disturbance of this enzyme is the primary genetic defect of this condition; inheritance of the defect is probably autosomal and dominant. The clinical manifestation of disturbances of porphyrin metabolism are precipitated, however, by additional factors, such as liver damage, alcohol, oestrogens and neoplastic growths. In the absence of these other pathogenic influences, the enzyme defect is compensated and does not result in disturbances of haem or haemoglobin synthesis, either in the liver or the bone marrow.

Carboxy-Lyases↗
PubMed1979

New type of hepatic porphyria with porphobilinogen synthase defect and intermittent acute clinical manifestation.

In two young patients with acute hepatic porphyria syndrome and persisting paralyses, which increased in intensity during intermittent occurring crisis, the activity of erythrocyte porphobilinogen synthase (delta-aminolevulinic acid dehydratase) was found to be considerably diminished, below 1% of the value of normal control persons. In contrast, the activity of uroporphyrinogen synthase was normal. Both patients have been excreting high quantities of delta-aminolevulinic acid and porphyrins in urine for years. Lead intoxication has definitively been excluded. Since the relatives also show lower activities in porphobilinogen synthase, the disease of these two patients is probably a new enzymatic type of inherited acute hepatic porphyria, the excretion profile of which is qualitatively completely different from those of the known acute porphyrias. The discovery of this porphyria confirms the theory of overlapping transition in the biochemical and clinical symptoms and analogies among acute hepatic porphyrias.

Acute Disease↗
PubMed1977

Postulated deficiency of hepatic heme and repair by hematin infusions in the "inducible" hepatic porphyrias.

There is compelling, indirect evidence of hepatic heme deficiency due primarily to the respective genetic errors of the three inducible hepatic porphyrias, acute intermittent porphyria, porphyria variegata, and hereditary coproporphyria. The induction is enhanced by exogenous inducers such as barbiturate, estrogens and other "porphyrogenic" chemicals and factors, including glucose deprivation. The newer knowledge of the induction of delta-aminolevulinic acid synthetase [delta-aminolevulinate synthase; succinyl--CoA:glycine C-succinyltransferase (decarboxylating), EC 2.3.1.37] in relation to inadequate heme, and repression by heme, stimulated early trials of hematin infusions to overcome the acute relapse in the foregoing inducible porphyrias. Recently this experience has been considerably expanded, 143 infusions of hematin having been given in 22 cases. Studies of the effect on the serum concentrations of delta-aminolevulinic acid and porphobilinogen have shown a highly significant decline, often to 0, especially of delta-aminolevulinic acid. A distinct relationship to the clinical severity of the attack has been evident in the frequency and magnitude of decline of serum delta-aminolevulinic acid and porphobilinogen. This was regularly associated with objective clinical improvement.

5-Aminolevulinate Synthetase↗
PubMed1979

Haem biosynthesis in cutaneous hepatic porphyria: comparison with alcoholism and liver disease.

The enzymes of haem biosynthesis have been measured in the peripheral blood of 13 patients with cutaneous hepatic porphyria. The activity of leucocyte delta-aminolaevulinic acid synthase was significantly elevated (p less than 0.001) as was that of erythrocyte porphobilinogen deaminase (p less than 0.05). Leucocyte ferrochelatase activity was depressed (p less than 0.001) and the activity of erythrocyte uroporphyrinogen decarboxylase did not significantly differ from control values. Similar enzyme activities were assayed in 12 chronic alcoholics and 8 patients with liver disease and the results differed markedly from those obtained from the porphyric patients. It is unlikely that the raised leucocyte delta-amino-laevulinic acid synthase activity can be attributed to alcohol ingestion or liver disease. A defect in the activity of uroporphyrinogen decarboxylase may exist in cutaneous hepatic porphyria but this could not be demonstrated in erythrocytes in this study.

5-Aminolevulinate Synthetase↗
PubMed1978

Hepatic porphyria: its rehabilitative evaluation and treatment.

In the rehabilitation of patients with hepatic porphyria, participation of a multidisciplinary team, concerned with diagnosis, evaluation, and treatment, is important. An approach which includes preventive medicine, specific and supportive medical treatment, and vigorous rehabilitative treatment of the neuropathic processes can lead to control of the disease and recovery of self-care and mobility, as illustrated by a case report.

Acute Disease↗
PubMed1978

[Laparoscopic findings in chronic hepatic porphyria (author's transl)].

The incidence and significance of gray patches on the hepatic surface found at laparoscopy was investigated in 50 patients with chronic hepatic porphyria. The color change was found in 38 patients; in 28 patients well defined gray dots were found. The incidence is not related to the degree of the metabolic disturbance. The gray patches contained 3-9 times more porphyrine than adjacent normally colored areas. Gray color and histological changes do coincide.

Female↗
PubMed1978

Protein binding of salicylate in cutaneous hepatic porphyria.

(1) Plasma protein binding of salicylate was studied in 14 patients with cutaneous hepatic porphyria (CHP) and 11 normal subjects using ultrafiltration with centrifugation (membrane cones) and continuous ultrafiltrations. (2) Albumin and haemoglobin levels were significantly reduced in patients with CHP, and salicylate binding by ultrafiltration/centrifugation was 65% compared with 84% in normal subjects. (3) Plasma porphyrin levels were raised, but did not correlate with salicylate binding, and protoporphyrin or uroporphyrin added to plasma did not alter the amount of drug bound. (4) Palmitate added to plasma reduced salicylate binding by 9 to 20% but a crossover of patient and normal plasma proteins and ultrafiltrates confirmed that no other ultrafiltrable metabolites present in patient plasma appeared to cause decreased binding. (5) Scatchard plots obtained by continuous ultrafiltration for normal and patient plasma showed a reduction in the number of primary and secondary binding sites and an increase in the intrinsic association constants for both these sites. (6) It was concluded that the decreased salicylate binding in CHP was due to a reduced albumin concentration and altered salicylate albumin interaction.

Blood Proteins↗
PubMed1975

Neuropathy in latent hereditary hepatic porphyria.

Peripheral nerve conduction velocoties were measured in 20 patients with acute intermittent porphyria and five with variegate porphyria and in 25 controls matched for age and sex. None of the porphyric patients had acute symptoms on examination, and nine had never had symptoms. Compared with the controls, patients had a significantly slower conduction velocity of the slower motor fibres of the ulnar nerve (P less than 0-001) and a slower sensory conduction velocity of the ulnar and median nerves (P less than 0-05). There was no significant difference between the patients and controls in the maximum motor conductionvelocity of the median, ulnar, deep peroneal, or posterior tibial nerves. Slight peripheral neuropathy seems to be associated with latent hereditary hepatic porphyria, even in patients who have never had symptoms.

Adolescent↗
PubMed1979

Brominated benzene induction of hepatic porphyria.

Unlike the highly porphyrinogenic fungicide hexachlorobenzene, hexabromobenzene was a poor inducer of porphyria. Similarly, 1,2-dibromobenzene and 1,2,4-tribromobenzene, while causing small increases in hepatic porphyrins, did not increase ALA synthetase or the urinary excretion of porphobilinogen (PBG), aminolevulinic acid (ALA) or porphyrins.

Aminolevulinic Acid↗
PubMed1979

[Hepatic porphyria].

Porphyria is making increasing demands on the attention of clinicians and research worker. An account is given of hepatic forms, since these have recently come into prominence on account of recent advances in the understanding of their metabolic, diagnostic and therapeutic aspects. A description of the physiopathology of porphyrin metabolism is followed by an examination of the incidence, genetic features, aetiology, pathogenesis, pathological anatomy, symptomatology, diagnosis, prognosis, and treatment of each form. Particular attention is devoted to intermittent acute and cutanea tarda porphyria, since these are more commonly encountered in practice. Personal experience gathered in a large series of cases of cutanea tarda porphyria is presented.

Aminolevulinic Acid↗