Jain Gaurav, Bennett Jeffrey I, Resch David S, Godwin John E
Department of Internal Medicine and Psychiatry (Drs Jain and Resch), Department of Psychiatry (Dr Bennett), and Department of Internal Medicine, Division of Hematology and Oncology, Simmons Cancer Institute (Dr Godwin), Southern Illinois University School of Medicine, Springfield.
Prim Care Companion CNS Disord. 2011;13(6). doi: 10.4088/PCC.11br01234.
Acute porphyrias are often misdiagnosed and most commonly present as atypical neuropsychiatric symptoms or acute abdominal pain. Clinicians should suspect acute porphyrias in patients presenting with variable neuropsychiatric symptoms and unexplained pain. Proper identification can lead to less iatrogenicity associated with porphyrinogenic agents, appropriate management, and a better patient outcome. The case of a patient with hereditary coproporphyria, one of the acute porphyrias, is presented to illustrate the broad manifestations, unsuspected diagnosis, and difficulties in management.
急性卟啉病常被误诊,最常见的表现为非典型神经精神症状或急性腹痛。对于出现多种神经精神症状且伴有不明原因疼痛的患者,临床医生应怀疑急性卟啉病。正确识别可减少与卟啉生成剂相关的医源性损害、进行恰当管理并改善患者预后。本文介绍了一例遗传性粪卟啉病(急性卟啉病之一)患者的病例,以说明其广泛的临床表现、未被怀疑的诊断情况以及管理上的困难。