title: Severe neurologic manifestations in acute intermittent porphyria developed after spine surgery under general anesthesia: a case report.
abstract: Porphyrias are inherited metabolic disorders resulting from a specific enzyme defect in the heme biosynthetic pathway. Porphyrias are induced by various precipitants. Clinical features include abdominal pain, neurologic manifestations, autonomic neuropathy, and mental disturbance. Diagnosis may be delayed because of variable symptoms that mimic other diseases and because of the rarity of of porphyrias. Although most patients with known porphyria can complete anesthesia and surgery safely, undiagnosed porphyric patients are in danger of porphyric crisis due to inadvertent exposure to precipitating drugs and environment. We report a case of a patient who experienced delayed emergence with neurological disturbance after general anesthesia, ultimately diagnosed as acute intermittent porphyria.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Yi Seul
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Kyung-Jee
authors.initials: KJ
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Hye Kyoung
authors.initials: HK
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Mae-Hwa
authors.initials: MH
authors.lastname: Kang
keywords: Delayed emergence from anesthesia; General anesthesia; Guillain-Barre Syndrome; Porphyrias; Wernicke encephalopathy