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

Author(s)

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

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

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

Fatima Qayyum Abbasi Federal Medical College, Islamabad, Pakistan

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.

Publication Details

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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