What is the typical clinical presentation of an acute porphyria attack?

By William Aird

  • Prodromic phase including minor behavioral changes such as:
    • Anxiety
    • Restlessness
    • Insomnia
  • Severe abdominal pain, but this pain might also be felt in the back or thighs.
  • Nausea, vomiting, and constipation are common.
  • Symptoms of increased sympathetic activity, including:
    • Tachycardia
    • Excess sweating
    • Hypertension

Physical exam usually normal.

Labs may show hyponatremia.

Urine may be red or dark-colored.

Most acute attacks last for no longer than 1 or 2 weeks.

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