Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report
Introduction: Acute hepatic porphyrias (AHP) are a rare group of inherited disorders caused by abnormal functioning of the heme synthesis pathway. Patients often present with diffuse abdominal pain, neurologic dysfunction, and hyponatremia. Case Report: We present a case of a 25-year-old female who...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2023-08-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/69m3b7g5 |
| _version_ | 1797736945855496192 |
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| author | Ryan K. Misek Massimo F. Riitano |
| author_facet | Ryan K. Misek Massimo F. Riitano |
| author_sort | Ryan K. Misek |
| collection | DOAJ |
| description | Introduction: Acute hepatic porphyrias (AHP) are a rare group of inherited disorders caused by abnormal functioning of the heme synthesis pathway. Patients often present with diffuse abdominal pain, neurologic dysfunction, and hyponatremia. Case Report: We present a case of a 25-year-old female who presented with AHP after implantation of progestin birth control. The patient was confused, markedly tachycardic and hypertensive, and complained of severe abdominal pain. Spot urine ordered during the emergency department workup was later found positive for porphyrins and porphobilinogen (PBG). Conclusion: Acute hepatic porphyrias typically present with nonspecific symptoms in young women and are often overlooked in the acute care setting. Spot urine testing for PBG and urine porphyrins should be initiated early in patients with clinical suspicion of AHP. |
| first_indexed | 2024-03-12T13:21:16Z |
| format | Article |
| id | doaj.art-48f20f15a99345649d17a7439e22fba8 |
| institution | Directory Open Access Journal |
| issn | 2474-252X |
| language | English |
| last_indexed | 2024-03-12T13:21:16Z |
| publishDate | 2023-08-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj.art-48f20f15a99345649d17a7439e22fba82023-08-25T22:33:31ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2023-08-017310.5811/cpcem.1490cpcem-7-144Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case ReportRyan K. Misek0Massimo F. Riitano1Midwestern University, Chicago College of Osteopathic Medicine, Department of Emergency Medicine, Downers Grove, IllinoisMidwestern University, Chicago College of Osteopathic Medicine, Downers Grove, IllinoisIntroduction: Acute hepatic porphyrias (AHP) are a rare group of inherited disorders caused by abnormal functioning of the heme synthesis pathway. Patients often present with diffuse abdominal pain, neurologic dysfunction, and hyponatremia. Case Report: We present a case of a 25-year-old female who presented with AHP after implantation of progestin birth control. The patient was confused, markedly tachycardic and hypertensive, and complained of severe abdominal pain. Spot urine ordered during the emergency department workup was later found positive for porphyrins and porphobilinogen (PBG). Conclusion: Acute hepatic porphyrias typically present with nonspecific symptoms in young women and are often overlooked in the acute care setting. Spot urine testing for PBG and urine porphyrins should be initiated early in patients with clinical suspicion of AHP.https://escholarship.org/uc/item/69m3b7g5 |
| spellingShingle | Ryan K. Misek Massimo F. Riitano Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report Clinical Practice and Cases in Emergency Medicine |
| title | Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report |
| title_full | Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report |
| title_fullStr | Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report |
| title_full_unstemmed | Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report |
| title_short | Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report |
| title_sort | implanted progestin causing pain and psychiatric disturbances in porphyria attack a case report |
| url | https://escholarship.org/uc/item/69m3b7g5 |
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