HYPERTENSIVE CRISIS IN PATIENTS WITH ACUTE INTERMITTENT PORPHYRIA

Abstract

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 di-uretics in maximal doses, but without a positive effect, so we de-cided to try with Glyceryl trinitrate intravenously. Control blood pressure was 170/100mmHg….130/80mmHg. Discussion: Por-phyria can be a diagnostic problem, because one of the manifes-tations can be abdominal pain. Conclusions: Comorbidities can be critical in the therapy of life threating conditions.