Porphyria hepatoerythropoetica E80.2

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 29.10.2020

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History
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Günther, 1967; Pinol Aguade, 1969

Definition
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Homozygous form of porphyria cutanea tarda with obligatory skin symptoms.

Etiopathogenesis
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Autosomal recessive inherited defect of uroporphyrinogen-1-decarboxylase leading to strongly reduced enzyme activity (5-10%).

Manifestation
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Childhood.

Clinical features
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Beginning of the first skin symptoms in childhood with phototoxic dermatitis within minutes to hours after sun exposure. S.a. Porphyria cutanea tarda.

Laboratory
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Elevated concentrations of free protoporphyrin in erythrocytes, plasma and stool. Prevalence of gallstones is increased!

Histology
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Like porphyria cutanea tarda.

General therapy
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Symptomatic. Textile and chemical light protection (see also light protection agents). Close internal control (danger of protoporphyrin-induced liver failure).

Internal therapy
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Continuous administration of carotenoids (e.g. carotaben 50-150 mg/day).

Literature
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  1. Elder et al (1981) Hepatoerythropoietic porphyria: a new uroporphyrinogen decarboxylase defect or homozygous porphyria cutanea tarda. Lancet 1: 916-919
  2. Ged C et al (2002) Description of a new mutation in hepatoerythropoietic porphyria and prenatal exclusion of a homozygous fetus. Arch Dermatol 138: 957-960
  3. Gunther WW (1967) The porphyrias and erythropoietic protoporphyria: an unusual case. Australas J Dermatol 9: 23-30
  4. Horina JH et al (2000) Epoetin for severe anemia in hepatoerythropoietic porphyria. N Engl J Med 342: 1294-1295
  5. Pinol J et al (1975) Porphyria hepato-erythrocytaire: une nouvelle forme de porphyrie. Ann Dermatol Venereol 102: 129-136
  6. Pinol Aguade J, Castells A et al (1969) A case of biochemically unclassifiable hepatic porphyria. Br J Dermatol 81: 270-275

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