Exacerbation of hereditary hepatic porphyria by surreptitious ingestion of an unusual provocative agent--a mouthwash preparation.

Abstract

EXACERBATIONS of acute intermittent porphyria are provoked by many commonly used drugs known to stimulate hepatic porphyrin-heme synthesis. In the patient described below, surreptitious ingestion of a seemingly innocuous agent — a mouthwash preparation — appeared to precipitate acute attacks of this disease.Case ReportA 48-year-old woman known to have acute intermittent porphyria was admitted to the Rockefeller University Hospital in severe clinical crisis in 1970. Urinary δ-aminolevulinic acid and porphobilinogen levels were highly elevated, and erythrocyte uroporphyrinogen synthetase activity was diagnostic for this genetic disease.1,2 She responded to therapy and was discharged within a month. A series of . . .