THE TREATMENT OF ACUTE PORPHYRIA WITH CHELATING AGENTS: A REPORT OF 21 CASES

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Article1 November 1957THE TREATMENT OF ACUTE PORPHYRIA WITH CHELATING AGENTS: A REPORT OF 21 CASESHENRY A. PETERS, M.D., SHERWYN WOODS, PETER L. EICHMAN, M.D., HANS H. REESE, M.D., F.A.C.P.HENRY A. PETERS, M.D.Search for more papers by this author, SHERWYN WOODSSearch for more papers by this author, PETER L. EICHMAN, M.D.Search for more papers by this author, HANS H. REESE, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-47-5-889 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAcute porphyria, especially its therapy, has challenged the clinician for years. The mortality rate when associated with severe neuropsychiatric manifestations is quoted as from 80 to 90%.1 Favorable therapeutic response to 2,3-dimercaptopropanol (BAL)‡ and disodium calcium ethylene diamine tetra-acetate (EDTA)§ was reported by Peters2, 3 in seven of 10 cases of acute porphyria, and by McCabe4 in one case of acute porphyria benefited by BAL administration. Paul and Thyresson5 and Schrumpf6 reported the ameliorating effects of BAL in cutaneous porphyria. Dean7 recorded one case not benefited by BAL.A total of 30 porphyria cases, including our previously reported patients,2, 3...Bibliography1. Markovitz M: Acute intermittent porphyria: a report of five cases and a review of the literature, Ann. Int. Med. 41: 1170, 1954. LinkGoogle Scholar2. Peters HA: BAL therapy of acute porphyrinuria, Neurology 4: 477, 1954. CrossrefMedlineGoogle Scholar3. Peters HA: Therapy of acute porphyria with BAL and other agents, Dis. Nerv. System 17: 177-183, 1956. MedlineGoogle Scholar4. McCabe ES: Case report: recovery in a case of ascending Landry paralysis due to porphyria, Am. Pract. 6: 878, 1955. Google Scholar5. PaulThyresson KGN: The effect of BAL on a case of "cutaneous porphyria," Acta dermat.-venereol. 34: 403, 1954. MedlineGoogle Scholar6. Schrumpf A: Porphyria improved after treatment with BAL, Acta med. Scandinav. 145: 338, 1953. CrossrefMedlineGoogle Scholar7. Dean G: Porphyria, Brit. M. J. 2: 1291, 1953. CrossrefMedlineGoogle Scholar8. Watson CJ: Porphyria, in Advances in internal medicine, edited by W. Dock and I. Snapper, Vol. 6, 1954, Year Book Publishers, Chicago, pp. 235-299. Google Scholar9. SchmidSchwartzWatson RSCJ: Porphyrin content of bone marrow and liver in the various forms of porphyria, Arch. Int. Med. 93: 167, 1954. CrossrefGoogle Scholar10. Kark RM: Clinical aspects of the major porphyrinopathies, M. Clin. North America 39: 11, 1955. CrossrefGoogle Scholar11. Rimington C: Haems and porphyrins in health and disease. Part II, Acta med. Scandinav. 143: 177, 1952. CrossrefGoogle Scholar12. Vanotti A: Porphyrins, 1954, Hilger and Watts, London. Google Scholar13. Shemin D: The succinate-glycine cycle; the role of delta-amino levulinic acid in porphyrin synthesis, in Ciba Foundation symposium on porphyrin biosynthesis and metabolism, edited by G. E. W. Wolstenholme and E. C. P. Millar, 1955, Little, Brown & Company, Boston, pp. 4-26. Google Scholar14. AldrichLabbeTalman RARFEL: A review of porphyrin metabolism with special reference to childhood, Am. J. M. Sc. 230: 675, 1955. CrossrefMedlineGoogle Scholar15. Chenoweth MB: Chelation as a mechanism of pharmacological action, Pharmacol. Rev. 8: 57, 1956. MedlineGoogle Scholar16. Vallee BL: The metabolic role of zinc, J. A. M. A. 162: 1053, 1956. CrossrefMedlineGoogle Scholar17. WackerUlmerVallee WEDDBL: Metalloenzymes and myocardial infarction, New England J. Med. 255: 449, 1956. CrossrefGoogle Scholar18. Borden's Review of nutritional research 17: No. 4, 1956. Google Scholar19. ScottFisher DAAM: Effect of zinc salts on the action of insulin, J. Pharmacol. and Exper. Therap. 55: 206, 1935. Google Scholar20. Nesbitt S: Acute porphyria, J. A. M. A. 124: 286, 1944. CrossrefGoogle Scholar21. BatchelorFehnelThomsonDrinker RPJWRMKR: A clinical and laboratory investigation of the effect of metallic zinc, of zinc oxide, and of zinc sulphide upon the health of workmen, J. Indust. Hyg. and Toxicol. 8: 322, 1926. Google Scholar22. Landouzy and Maumené: De l'intoxication zincale observée chez les ouvriers tordeurs de fils galvanisés, Gaz. méd. de Paris 5: 409, 1850. Google Scholar23. Sacher A: Zur Kenntnis der Wirkung der Zinksalze, Arb. des pharmakol. Inst. zu Dorpat, Stuttgart 9: 88, 1893. Google Scholar24. Bashour FA: Lead poisoning with special reference to porphyrin metabolism, Bull. Minn. Hospitals & Med. Found. 26: 423, 1955. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Madison, Wisconsin*Presented at the Thirty-eighth Annual Session of The American College of Physicians, Boston, Massachusetts, April 11, 1957.From the Department of Neurology, University of Wisconsin Medical School, Madison, Wisconsin.†Senior student in medicine, University of Wisconsin.‡Referred to henceforth as BAL.§Referred to henceforth as EDTA.∥Disodium calcium versenate was supplied by the Riker Laboratories and bisodium versenate by Abbott Laboratories.Requests for reprints should be addressed to H. A. Peters, M.D., Neurology Department, University Hospitals, Madison, Wisconsin. 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FAVOURABLE RESULTS IN TWELVE CASES TREATED BY CHELATIONTransient excess urinary excretion of antidiuretic material in acute intermittent porphyria with hyponatremia and hypomagnesemiaFactors affecting the excretion of porphyrin precursors by patients with acute intermittent porphyria I. The effect of dietPorphyrias and Porphyrin Metabolism, with Special Reference to Porphyria in ChildhoodPorphyria As A Problem In AnaesthesiaToxic side effects of ethylenediaminetetraacetic acidHYPONATREMIA IN ACUTE INTERMITTENT PORPHYRIA PROBABLY RESULTING FROM INAPPROPRIATE SECRETION OF ANTIDIURETIC HORMONE*Ablagerungskrankheiten körpereigener StoffwechselprodukteLECTURE I: THE PORPHYRINOPATHIESPorphyric Psychosis and Chelation TherapyZur Pathogenese der Porphyria cutanea tardaTHE USE OF CHELATING AGENTS IN THE TREATMENT OF ACUTE PORPHYRIA*JOHN T. GALAMBOS, M.D., LAMAR B. PEACOCK, M.D.Porphyria cutanea tardaDiscussion on Some Clinical, Genetic and Biochemical Aspects of Metabolic Disorders of the Nervous SystemPorphyria Treated with Prochlorperazine 1 November 1957Volume 47, Issue 5Page: 889-899KeywordsAdrenocorticotropic hormoneBronchoalveolar lavageCalciumDeath ratesEthyleneEthylenediaminetetraacetic acidExcretionNeurologyPorphyriaZinc ePublished: 1 December 2008 Issue Published: 1 November 1957 PDF downloadLoading ...