D'Alessandro Gandolfo L, Macrì A, Biolcati G, Rossi F, Cirelli A, Barlattani A, Topi G C
Recenti Prog Med. 1989 Mar;80(3):140-1.
A case is described, that came to our attention for suspected acute intermittent porphyria, with abdominal pain and ascending tetraplegia. The patient (HIV positive and with a HBsAg positive chronic aggressive hepatitis) was a heroin addict. In urine: high porphyrins with extremely increased delta amino-levulinic acid (ALA) and normal porphobilinogen. High protoporphyrin was present in blood red cells. The lead poisoning was confirmed by a very low ALA-dehydratase activity in erythrocytes and a high content of lead in urine and plasma. With Ca-versenate and penicillamine the abdominal and neurological symptoms rapidly disappeared. The possibility of contact with lead, professional or environmental, was ruled out. It was found however, that shortly before the appearance of symptoms, the patient had used a batch of unrefined brown sugar heroin, which was probably mixed with lead salts. It is noteworthy that during the same period, other young heroin addicts died with similar symptoms.
描述了一例因疑似急性间歇性卟啉症引起我们注意的病例，患者有腹痛和上行性四肢瘫。该患者为海洛因成瘾者（HIV阳性且患有慢性侵袭性乙肝表面抗原阳性肝炎）。尿液检查：卟啉含量高，δ-氨基-γ-酮戊酸（ALA）极度升高，而尿卟胆原正常。红细胞中存在高含量的原卟啉。红细胞中极低的ALA脱水酶活性以及尿液和血浆中高含量的铅证实了铅中毒。使用依地酸钙钠和青霉胺后，腹部和神经症状迅速消失。排除了职业或环境接触铅的可能性。然而，发现就在症状出现前不久，患者使用了一批未精制的红糖海洛因，这批海洛因可能混有铅盐。值得注意的是，在同一时期，其他年轻海洛因成瘾者也死于类似症状。
