DOI: 10.12890/2020_001688

Variegate Porphyria Triggered by Acute Hepatitis A Infection

Authors

  • Daniel Micallef Department of Dermatology, Mater Dei Hospital, Msida, Malta
  • Charlton Agius Department of Pathology, Mater Dei Hospital, Msida Malta
  • Charles Mallia-Azzopardi Department of Medicine, Mater Dei Hospital, Msida Malta
  • Gerald Buhagiar Department of Pathology, Mater Dei Hospital, Msida Malta
  • Lawrence Scerri Department of Medicine, Mater Dei Hospital, Msida Malta

daniel.b.micallef@gov.mt

Keywords

Variegate porphyria, hepatitis A

Abstract

Background: Variegate porphyria (VP) is a rare disorder of haem biosynthesis. We report a novel association with hepatitis A infection.

Patient and methods: A 31-year-old man was diagnosed with acute hepatitis A infection. During recovery, he presented with abdominal pain and a photoaggravated blistering skin eruption.

Results: Urine porphyrin precursors were markedly raised with high coproporphyrin III isomer levels. Faecal protoporphyrin levels were markedly increased and a maximum plasma fluorescence emission at 629 nm was noted. 

Discussion: Acute hepatitis A infection, and the associated metabolic stress exerted on the haem biosynthetic pathway, induced overt presentation of latent VP.

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References

  1. Puy H, Gouya L, Deybach JC. Porphyrias. Lancet 2010;375:924–937.
  2. Horner ME, Alikhan A, Tintle S, Tortorelli S, Davis DM, Hand JL. Cutaneous porphyrias part I: epidemiology, pathogenesis, presentation, diagnosis, and histopathology. Int J Dermatol 2013;52(12):1464–1480.
  3. Woolf J, Marsden JT, Degg T, Whatley S, Reed P, Brazil N, et al. Best practice guidelines on first-line laboratory testing for porphyria. Ann Clin Biochem 2017;54(2):188–198.
  4. Tintle S, Alikhan A, Horner ME, Hand JL, Davis DM. Cutaneous porphyrias part II: treatment strategies. Int J Dermatol 2014;53(1):3–24.

Published

2020-09-22

Issue

Vol. 7 No. 12 (2020)

How to Cite

1.
Micallef D, Agius C, Mallia-Azzopardi C, Buhagiar G, Scerri L. Variegate Porphyria Triggered by Acute Hepatitis A Infection. EJCRIM [Internet]. 2020 Sep. 22 [cited 2026 Nov. 4];7(12). Available from: https://ejcrim.com/index.php/ejcrim/article/view/1688

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