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Year : 2021  |  Volume : 31  |  Issue : 1  |  Page : 67-70

Recurrent seizures in an adolescent female-A daunting puzzle

Department of Nephrology, Government Stanley Medical College, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. N D Srinivasa Prasad
92/144, B Block, F4, Ramyam Apartment, Vellala Street, Purasaiwakkam, Chennai - 600 084, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_192_19

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Acute porphyrias are metabolic disorders resulting from deficiency of a specific enzyme involved in heme biosynthetic pathway. These deficiencies also affect normal renal physiology, as kidneys are also involved in heme synthesis. Sometimes, this could even lead to end stage renal disease. Acute Intermittent Porphyria, an autosomal dominant disorder arising from half-normal activity of hydroxymethylbilane synthase, is characterized by occurrence of vague neurovisceral attacks (abdominal pain, nausea, vomiting, constipation and neuropsychiatric symptoms), with urinary excretion of porphyrin precursors, such as 5-Amino-levulinic acid (ALA) and Porphobilinogen (PBG). Acute attacks are triggered by dehydration, diarrhea, steroids, low calorie diets. Treatment includes avoidance of precipitating factors, adequate hydration, high carbohydrate diet and heme replacement. Here, we present an adolescent female who had presented with recurrent abdominal pain, dyselectrolyemia with associated seizures, was diagnosed with Acute Intermittent Porphyria and recovered well with symptomatic management.


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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07