[Acute intermittent porphyria and inappropriate ADH syndrome].
A 44-year-old woman complained of abdominal pain of 4 days' duration accompanied by vomiting and painful urination. The admitting physician noted neurologic signs consistent with axonal polyneuropathy and hyponatremia. In the absence of other explanations for the syndrome, SIADH was diagnosed. Because of the nonspecific nature of the observations, the patient was assessed by various specialists and admitted to the anesthetic recovery unit due to worsening of neurologic signs and suspicion of acute intermittent porphyria. The diagnosis was confirmed by laboratory findings of elevated d-aminolevulinic acid and porphobilinogen levels and normal stool porphyrins. The patient improved with intravenous hematin infused over 4 days.
Tébar
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Servicio de Anestesiología y Reanimación, Hospital de Basurto, Bilbao. mariateresa.tebarsoto@osakidetza.net
Aguilera
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D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000622:Aminolevulinic Acid / Q000097:blood; D003306:Coproporphyrins / Q000032:analysis; D057210:Delayed Diagnosis; D004040:Dietary Carbohydrates / Q000627:therapeutic use; D005243:Feces / Q000737:chemistry; D005260:Female; D006427:Hemin / Q000627:therapeutic use; D006801:Humans; D007010:Hyponatremia / Q000178:diet therapy / Q000209:etiology; D007177:Inappropriate ADH Syndrome / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology; D011162:Porphobilinogen / Q000652:urine; D017118:Porphyria, Acute Intermittent / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D011782:Quadriplegia / Q000209:etiology; D017673:Sodium Chloride, Dietary / Q000627:therapeutic use; D014839:Vomiting / Q000209:etiology
D003306:Coproporphyrins; D004040:Dietary Carbohydrates; D017673:Sodium Chloride, Dietary; D006427:Hemin; D011162:Porphobilinogen; D000622:Aminolevulinic Acid