title: Porphyria and anorexia: cause and effect.
abstract: Porphyrias are hereditary disorders related to impaired biosynthesis of heme and characterized by multisystemic manifestations. Acute intermittent porphyria (AIP) is the most common acute subtype of the disease, and often associated with psychiatric symptoms. We here report a patient who developed acute flaccid paralysis after remarkable weight loss, which was related to an eating disorder (anorexia nervosa). After an extensive neurologic workup, he was diagnosed with AIP. This case emphasizes a deleterious vicious cycle between AIP and anorexia: porphyria may lead to anorexia and the carbohydrate restriction may lead to recurrent porphyric attacks. Therefore, an interruption of this cycle with psychiatric approaches to the eating disorders is crucial for long-term therapeutic efficacy.
authors.affiliation: Department of Neurology , UNICAMP , Campinas, São Paulo , Brazil.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Martins
authors.affiliation: Department of Psychiatry , UNICAMP , Campinas, São Paulo , Brazil.
authors.forename: Barbara E S
authors.initials: BE
authors.lastname: Bandeira
authors.affiliation: Department of Neurology , UNICAMP , Campinas, São Paulo , Brazil.
authors.forename: Alberto R M
authors.initials: AR
authors.lastname: Martinez
authors.affiliation: Department of Psychiatry , UNICAMP , Campinas, São Paulo , Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Dalgalarrondo
authors.affiliation: Department of Neurology , UNICAMP , Campinas, São Paulo , Brazil.
authors.forename: Marcondes C
authors.initials: MC
authors.lastname: França