title: Use of gonadotropin-releasing hormone analog with tibolone to prevent cyclic attacks of acute intermittent porphyria.
abstract: A 25-year-old woman with a 10-year history of recurrent attacks of acute abdominal pain just before menstrual periods had acute intermittent porphyria (AIP) diagnosed when she was 23.5 years old. Many acute attacks required hospitalization. Suppression of the menstrual cycle with a gonadotropin-releasing hormone analog (GnRHa; triptorelin) and tibolone administration as add-back therapy resulted in absence of acute porphyric attacks. The patient had no acute attacks over a 1-year follow-up period. This case suggests that long-term GnRHa therapy with tibolone add-back may be a therapeutic option for patients with AIP.
authors.affiliation: Institut Clinic de Ginecologia, Obstetricia i Neonatologia, Hospital Clinic, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Castelo-Branco
authors.forename: J J
authors.initials: JJ
authors.lastname: Vicente
authors.forename: J A
authors.initials: JA
authors.lastname: Vanrell
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D045930:Anabolic Agents / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use*; D006801:Humans; D008599:Menstruation Disturbances / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D001523:Mental Disorders / Q000209:etiology; D009652:Norpregnenes / Q000627:therapeutic use*; D010507:Periodicity; D017118:Porphyria, Acute Intermittent / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D045930:Anabolic Agents; D005300:Fertility Agents, Female; D009652:Norpregnenes; D007987:Gonadotropin-Releasing Hormone; C027385:tibolone