Porphyria cutanea tarda occurring in a patient with renal failure, systemic lupus erythematosus and chronic hepatitis C infection treated with hemodialysis.
The diagnosis and management of porphyria cutanea tarda (PCT) is complicated when it occurs in the context of renal failure, chronic hemodialysis, and anemia. We report a case of a woman who presented with painful acral blisters and hyperpigmentation. Her medical history included systemic lupus erythematosus, chronic hepatitis C infection, and renal failure necessitating chronic hemodialysis with a baseline anemia. A highly elevated serum porphyrin level led to the diagnosis of PCT. Treatment with small repeated phlebotomies and concomitant administration of erythropoietin was effective in managing her PCT.
Lee
P K
PK
Department of Dermatology, New York-Presbyterian Hospital, Columbia Presbyterian Center, New York, USA.
Abrahams
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I
Bickers
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DR
D000328:Adult; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D018962:Phlebotomy; D017119:Porphyria Cutanea Tarda / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006435:Renal Dialysis; D018570:Risk Assessment
D004921:Erythropoietin