Porphyria is a condition that affects how heme is made and broken down by the body. Heme is the part of hemoglobin that carries oxygen to the cells of the body.
Hemoglobin is the main oxygen-carrying component of blood. Porphyrins are compounds in the body that affect the way hemoglobin is made, stored, and used.
A person with porphyria makes and excretes excessive amounts of porphyrins. This often causes abnormally high levels of heme in the blood. There are several kinds of porphyria. Porphyrias are classified by where in the body the excess porphyrins are made. They include:
Most cases of porphyria are caused by genetic disorders. Some cases are caused by toxic substances, such as ingestion or exposure to lead. Menstruation may increase symptoms in women.
Symptoms vary, depending on the type of porphyria. Symptoms that may occur with most of the porphyrias include:
Hepatic porphyria may cause these additional symptoms:
The diagnosis of porphyria depends on the symptoms and what type of porphyria is suspected. Steps in diagnosis may include:
Prevention of porphyria is not always possible. Avoiding things that trigger symptoms may decrease the risk of symptoms. These triggers include:
A person with porphyria may have recurrent and severe symptoms. Some forms of porphyria may lead to gallstones or chronic skin or liver problems. Electrolyte or salt imbalances in the blood can occur. If untreated, porphyria may also lead to respiratory distress, shock, and death.
Porphyria is not contagious. It can be passed genetically to offspring.
Treatment depends on the type of porphyria. Treatment of acute, or short term, intermittent porphyria includes intravenous fluids and glucose. Other treatments may include:
Pain medications may cause stomach upset, irritability, and drowsiness. Surgery poses a risk of bleeding, infection, and allergic reaction to anesthesia.
A person with porphyria may have relapses, in which the condition worsens and symptoms return.
The person is monitored for relapses. Blood and urine tests may also be used to monitor the levels of porphyrins in the blood and urine. Further treatment will be given when symptoms or attacks occur. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Bill Harrison, MD
Date Written:
Editor:Duff, Ellen, BA
Edit Date:10/09/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/05/01
Harrison's Principles of Internal Medicine, Fauci et al, 1998
Complete Guide to Symptoms, Illness, and Surgery, Griffith, 2000
Professional Guide to Diseases, Burlew et al, 1995