DeMaria Bethani L, Franke Aaron J
Division of Hematology and Oncology, Sidney Health Center Cancer Care, Sidney, USA.
Cureus. 2024 Nov 20;16(11):e74091. doi: 10.7759/cureus.74091. eCollection 2024 Nov.
We present a case of a 34-year-old woman with a 12-week history of blistering skin lesions, ultimately diagnosed with co-existing porphyria cutanea tarda (PCT) and hereditary hemochromatosis (HH) due to a homozygous C282Y mutation. The patient's discovered genetic predisposition to iron overload played a key role in the development of clinically symptomatic PCT. Treatment with serial therapeutic phlebotomy was started, dramatically improving her symptomatic cutaneous disease, iron indices, and liver function tests. The case brings to the fore the need for thorough diagnostics including genetic testing and the early identification and treatment of iron overload in patients with PCT. This case emphasizes the clinical effectiveness of reducing plasma iron by phlebotomy and underscores the importance of intervention to prevent the long-term complications of pathologic iron overload in PCT. This case report serves to supplement the paucity of existing literature detailing the complex association between PCT and HH and the diagnostic challenges of identifying these commonly co-existing conditions.
我们报告一例34岁女性,有12周的皮肤水疱性病变病史,最终因纯合子C282Y突变被诊断为迟发性皮肤卟啉病(PCT)和遗传性血色素沉着症(HH)并存。患者发现的铁过载遗传易感性在有临床症状的PCT发展中起关键作用。开始采用系列治疗性放血疗法,显著改善了她有症状的皮肤疾病、铁指标和肝功能检查。该病例凸显了进行包括基因检测在内的全面诊断以及对PCT患者早期识别和治疗铁过载的必要性。本病例强调了通过放血减少血浆铁的临床有效性,并强调了干预以预防PCT中病理性铁过载长期并发症的重要性。本病例报告旨在补充现有文献中关于PCT与HH之间复杂关联以及识别这些常见并存疾病的诊断挑战的不足。