Hypertensive Crisis in Patients with Acute Intermittent Porphyria

Introduction

Acute intermittent porphyria (AIP) is the most common and the most severe form of acute hepatic porphyria.

Case report

Patient, 39 years old, was admitted to the Emergency Department because of abdominal pain. Abdominal pain started 5 days before the admission. The diagnostic research in his hospital showed presence of a stone in the right kidney, and the patient was transported to the other Clinical Centre, where a common urine test showed: high values of delta - aminolevulinic acid and porphobilinogen. The patient was transported to our Clinical Centre.

At the admission, abdominal pain decreased, but the patient had a hypertensive crisis with a headache, tearing eyes, swelling, anxiety. Common laboratory tests were in reference range, except creatinine, CRP, arterial blood gas analysis, urine test. The hypertensive crisis was treated by beta blockers and diuretics in maximal doses, but without a positive effect, so we decided to try with Glyceryl trinitrate intravenously. Control blood pressure was 170/100mmHg….130/80mmHg.

Discussion

Porphyria can be a diagnostic problem, because one of the manifestations can be abdominal pain.

Conclusions

Comorbidities can be critical in the therapy of life threating conditions.