Avtor/Urednik		Lainščak, Mitja; Kocijančič, Borut
Naslov		Akutna jetrna porfirija pri sladkornem bolniku
Prevedeni naslov		Acute hepatic porphyria in diabetic patient
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 42, št. 4
Leto izdaje		2003
Obseg		str. 413-7
Jezik		slo
Abstrakt		Acute hepatic porphyrias are rare disorders of heme metabolism and can potentially be lethal. Diagnosis is based on the clinical presentation and laboratory analysis of urine. Adequate and early treatment can prevent further complications. The paper presents a case of a 30-year-old patient with known diabetes mellitus, who had several episodes of abdominal pain over the past three years. During his second hospitalization, acute hepatic porphyria was diagnosed, which was probably due to hypoglycemia and psychological stress. After symptomatic treatment, the patient was discharged with detailed instructions on the factors which may precipitate acute attacks. Upon the outpatient control examination, the patient had no symptoms or clinical or laboratory signs of porphyria. Acute hepatic porphyria is often missed. Normoglycemic patients with diabetes mellitus can have other precipitating factors. Education of patients and prevention of precipitating factors can prevent acute attacks.
Izvleček		Akutne jetrne porfirije so redke motnje v sintezi hema, ki so lahko smrtne. Diagnoza temelji na klinični sliki in laboratorijski analizi urina ter blata. Z ustreznim in pravočasnim zdravljenjem lahko preprečimo nadaljnje zaplete. Prikazan je primer 30-letnega sladkornega bolnika, ki je tri leta občasno imel bolečine v trebuhu. Med drugim bolnišničnim zdravljenjem smo postavili diagnozo akutne jetrne porfirije, verjetno sprožene s kombinacijo hipoglikemije in psihičnega stresa. Potrebno je bilo le simptomatsko zdravljenje. Ob odpustu je dobil natančna navodila glede preprečevanja sprožilnih dejavnikov in ob kontrolnem pregledu je bil brez simptomov in kliničnih ali laboratorijskih znakov bolezni. Akutna jetrna porfirija je pogosto spregledana. Pri sladkornih bolnikih moramo ob normoglikemiji pomisliti tudi na druge sprožilne dejavnike. Preprečevanje sprožilnih dejavnikov in izobraževanje bolnikov lahko prepreči pojav akutnih napadov.
Deskriptorji		PORPHYRIA, HEPATIC DIABETES MELLITUS ADULT PRECIPITATING FACTORS HEME ABDOMINAL PAIN HYPOGLYCEMIA PORPHYRINS