Patients with one of the hepatic porphyrias may develop an acute porphyric attack following a triggering event. The symptoms can be made worse by administering drugs that are porphyrinogenic. Attacks can be fatal.
Constitutional symptoms:
(1) fever
(2) sweating
Abdominal:
(1) vomiting
(2) severe abdominal pain
(3) constipation
(4) ileus with abdominal distension
Cardiovascular:
(1) hypertension
(2) tachycardia
(3) cardiac arrhythmias
Neurologic findings:
(1) pains in head, neck, chest and/or limbs without tenderness to palpation
(2) sensory loss
(3) muscle weakness
(4) psychiatric disorders including anxiety, depression, confusion, hallucinations, delusions, paranoia
(5) tremor
(6) peripheral neuropathy
(7) inappropriate secretion of ADH with hyponatremia
Severe attacks may result in:
(1) paralysis
(2) seizures
(3) respiratory arrest
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