Common symptoms and signs of acute porphyria.
| Symptoms and Signs . | Estimated Incidence, % . | Comment . |
|---|---|---|
| Reprinted with permission from Anderson KE, Bloomer JR, Bonkovsky HL, et al. Recommendations for the diagnosis and treatment of the acute porphyrias. Ann Intern Med . 2005 ;142 :439 –450. | ||
| Gastrointestinal | ||
| Abdominal pain | 85–95 | Usually unremitting (for hours or longer) and poorly localized but can be cramping. Neurologic in origin and rarely accompanied by peritoneal signs, fever, or leukocytosis. |
| Vomiting | 43–88 | Nausea and vomiting often accompany abdominal pain. |
| Constipation | 48–84 | May be accompanied by bladder paresis. |
| Diarrhea | 5–12 | |
| Neurologic | ||
| Pain in extremities, back, chest, neck, or head | 50–70 | Pain may begin in the chest or back and move to the abdomen. Extremity pain indicates involvement of sensory nerves, with objective sensory loss reported in 10%–40% of cases. |
| Paresis | 42–68 | May occur early or late during a severe attack. Muscle weakness usually begins proximally rather than distally and more often in the upper than lower extremities. |
| Respiratory paralysis | 9–20 | Preceded by progressive peripheral motor neuropathy and paresis. |
| Mental symptoms | 40–58 | May range from minor behavioral changes to agitation, confusion, hallucinations, and depression. |
| Convulsions | 10–20 | A central neurologic manifestation of porphyria or due to hyponatremia, which often results from syndrome of inappropriate antidiuretic hormone secretion or sodium depletion. |
| Cardiovascular | ||
| Tachycardia | 64–85 | May warrant treatment ot control rate, if symptomatic (see text). |
| Systemic arterial hypertension | 36–55 | May require treatment during acute attacks, and sometimes becomes chronic. |
| Symptoms and Signs . | Estimated Incidence, % . | Comment . |
|---|---|---|
| Reprinted with permission from Anderson KE, Bloomer JR, Bonkovsky HL, et al. Recommendations for the diagnosis and treatment of the acute porphyrias. Ann Intern Med . 2005 ;142 :439 –450. | ||
| Gastrointestinal | ||
| Abdominal pain | 85–95 | Usually unremitting (for hours or longer) and poorly localized but can be cramping. Neurologic in origin and rarely accompanied by peritoneal signs, fever, or leukocytosis. |
| Vomiting | 43–88 | Nausea and vomiting often accompany abdominal pain. |
| Constipation | 48–84 | May be accompanied by bladder paresis. |
| Diarrhea | 5–12 | |
| Neurologic | ||
| Pain in extremities, back, chest, neck, or head | 50–70 | Pain may begin in the chest or back and move to the abdomen. Extremity pain indicates involvement of sensory nerves, with objective sensory loss reported in 10%–40% of cases. |
| Paresis | 42–68 | May occur early or late during a severe attack. Muscle weakness usually begins proximally rather than distally and more often in the upper than lower extremities. |
| Respiratory paralysis | 9–20 | Preceded by progressive peripheral motor neuropathy and paresis. |
| Mental symptoms | 40–58 | May range from minor behavioral changes to agitation, confusion, hallucinations, and depression. |
| Convulsions | 10–20 | A central neurologic manifestation of porphyria or due to hyponatremia, which often results from syndrome of inappropriate antidiuretic hormone secretion or sodium depletion. |
| Cardiovascular | ||
| Tachycardia | 64–85 | May warrant treatment ot control rate, if symptomatic (see text). |
| Systemic arterial hypertension | 36–55 | May require treatment during acute attacks, and sometimes becomes chronic. |