Abstract

To the Editor: We were intrigued by the cover image for the November 2011 issue of Clinical Chemistry , which showed a cover picture claiming that Mary Queen of Scots had a diagnosis of acute porphyria. The diagnosis of porphyria is usually assigned when a presenting patient is currently symptomatic; the range of indicative symptoms is diverse but relatively well defined. The 3 most common acute porphyrias are hereditary coproporphyria, variegate porphyria, and acute intermittent porphyria, all inherited as autosomal dominant disorders. Many individuals who inherit the enzyme abnormalities remain asymptomatic through out life. Abdominal pain is the most common symptom of an …

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