Worsening abdominal pain leading to false laparotomy: A case of acute intermittent porphyria | [Journal of Pakistan Medical Association • 2024]

Author(s):

1. Tehreem Farah: Department of Obstetrics and Gynaecology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

2. Hania Batool: Department of Obstetrics and Gynaecology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

3. Nasir Ashraf: Department of General Medicine, Pakistan Institute of Medical Sciences, Islamabad, Pakistan

4. Fatima Qayyum Abbasi: Federal Medical College, Islamabad, Pakistan

5. Aisha Nasir: Dera Ghazi Khan Medical College, Dera Ghazi Khan, Pakistan

Abstract:

Acute intermittent porphyria (AIP), one of the most severe types of acute hepatic porphyria, is an autosomal dominant inherited disorder of heme biosynthesis. We present a case of a 16-year-old girl who presented with severe abdominal pain, subjected to a laparotomy and later developed seizures and other neurological manifestations. Initial investigations showed hyponatraemia. Magnetic Resonance Imaging of brain showed cerebritis. She underwent several investigations including an ultrasound of abdomen, a computed tomography scan of abdomen and pelvis, cerebrospinal fl uid routine examination and culture, and autoimmune investigation which were found to be normal. Later urine porphobilinogen levels were found to be raised. The diagnosis was made based on investigation and clinical symptoms. AIP should be suspected when a patient presents with chronic abdominal pain and neurological symptoms.

Page(s): 2003-2005

DOI: 10.47391/JPMA.10209

Published: Journal: Journal of Pakistan Medical Association, Volume: 74, Issue: 11, Year: 2024

Keywords:

Tonicclonic seizures , acute abdomen , Appendicitis , Hyponatremia , Acute intermittent porphyria , false laparotomy

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