title: Acute exacerbation of hereditary coproporphyria mimics early surgical infection following intrathecal pump implantation for chronic abdominal pain: A case report.
abstract: OBJECTIVE
  Pain physicians should also be aware of rare complications that can occur after intrathecal pump (ITP) placement. One such rare complication includes an acute exacerbation of hereditary coproporphyria (HCP).
  
  
  METHODS
  We present a case report that illustrates how an acute exacerbation of HCP can mimic an early surgical post-procedure infection after ITP implantation.
  
  
  RESULTS
  The patient's rapid onset of symptoms two hours after the procedure keyed into HCP as the underlying cause, as acute wound infections rarely occur in the several hours following surgery. After symptomatic treatment of her HCP acute exacerbation, the patient clinically improved without the development of further symptoms or adverse sequelae. She reported considerable pain relief with the implanted drug delivery system.
  
  
  CONCLUSIONS
  In a setting with multiple confounders, a methodical history and physical examination, close monitoring, and a comprehensive understanding of potential complications can prevent unnecessary ITP extraction and streamline the delivery of appropriate care.
authors: Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA. linzhoumd@yahoo.com
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