Porphyria disorders

In this session, Karl Anderson, MD and Taha Bat, MD discuss porphyria, focusing on the diagnosis and management of acute hepatic porphyria (AHP). The video explains that AHP is a group of four rare, autosomal dominant disorders, with the most common being acute intermittent porphyria (AIP), hereditary coproporphyria (HCP), and variegate porphyria (VP). The symptoms of AHP are often non-specific, with severe, unexplained abdominal pain being the most common symptom. Diagnosis is confirmed by testing for high levels of ALA and PBG in the urine. Treatment for acute attacks includes removing exacerbating factors and administering specific treatments like panhematin. For patients with frequent attacks, givosiran, an RNAi therapeutic, is used for prophylaxis. The video also touches on potential long-term complications, such as chronic liver and kidney disease, and the risk of iron overload with repeated panhematin use.

Key Learning Points:

• Acute hepatic porphyria (AHP) is a group of rare, genetic disorders that can cause acute, life-threatening attacks.
• Symptoms are non-specific, with the most common being severe abdominal pain. Neurological symptoms and dark urine may also occur.
• AHP is diagnosed by testing for elevated levels of ALA and PBG in the urine, as genetic testing can be unreliable due to low penetrance.
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