Late-onset hepatoerythropoietic porphyria presenting with facial deformities and erythrodontia

Authors

  • Suchada Triviboonvanich Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sarawut Junnu Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Chatchawan Srisawat Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Narumol Silpa-archa Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Hepatoerythropoietic porphyria, facial deformities, erythrodontia, late-onset

Abstract

Hepatoerythropoietic porphyria (HEP) is a nonacute porphyria inherited as an autosomal recessive disorder due to either a homozygous or compound heterozygous deficiency of uroporphyrinogen decarboxylase (UROD). The incidence of HEP is extremely rare, with fewer than 40 cases reported to date. The typical onset is in early childhood, and it usually presents with severe photosensitivity, mutilating scarring, and hypertrichosis. We report a 48-year-old man with teenage onset (15 years of age) of HEP.

References

1. Bickers DR. The prophyrias. In: Goldsmith LA, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8 ed. United States: Mc Graw-Hill Companies; 2012. p. 1538-73.

2. Peerapittayamongkol C, Srisawat C, Junnu S, Kanyok S, Soiampornkul R, Poonsawas I, Neungton N. Porphyrias diagnosed types by HPLC analysis: 10 years of Siriraj experience. Siriraj Med J 2007;59:356-60.

3. Deacon AC, Elder GH. ACP Best Practice No 165: front line tests for the investigation of suspected porphyria. J Clin Pathol 2001; 54: 500-7.

4. Moran-Jimenez MJ, Ged C, Romana M, et al. Uroporphyrinogen decarboxylase: complete human gene sequence and molecular study of three families with hepatoerythropoietic porphyria. Am J Hum Genet 1996; 58: 712-21.

5. Balwani M, Desnick RJ. The porphyrias: advances in diagnosis and treatment. Blood 2012; 120: 4496-504.

6. Cantatore-Francis JL, Cohen-Pfeffer J, Balwani M, et al. Hepatoerythropoietic porphyria misdiagnosed as child abuse: cutaneous, arthritic, and hematologic manifestations in siblings with a novel UROD mutation. Arch Dermatol 2010; 146: 529-33.

7. Karim Z, Lyoumi S, Nicolas G, Deybach JC, Gouya L, Puy H. Porphyrias: A 2015 update. Clin Res Hepatol Gastroenterol 2015; 39: 412-25.

8. Phillips JD, Whitby FG, Stadtmueller BM, Edwards CQ, Hill CP, Kushner JP. Two novel uroporphyrinogen decarboxylase (URO-D) mutations causing hepatoerythropoietic porphyria (HEP). Transl Res 2007; 149: 85-91.

9.Ramanujam VM, Anderson KE. Porphyria Diagnostics-Part 1: A Brief Overview of the Porphyrias. Curr Protoc Hum Genet 2015; 86: 17.20.1-26.

10. Remenyik E, Lecha M, Badenas C, et al. Childhood-onset mild cutaneous porphyria with compound heterozygotic mutations in the uroporphyrinogen decarboxylase gene. Clin Exp Dermatol 2008; 33: 602-5.

11. Armstrong DK, Sharpe PC, Chambers CR, Whatley SD, Roberts AG, Elder GH. Hepatoerythropoietic porphyria: a missense mutation in the UROD gene is associated with mild disease and an unusual porphyrin excretion pattern. Br J Dermatol 2004; 151: 920-3.

12. Horina JH, Wolf P. Epoetin for severe anemia in hepatoerythropoietic porphyria. N Engl J Med 2000; 342: 1294-5.

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Published

2019-06-25

How to Cite

Triviboonvanich, S., Junnu, S., Srisawat, C., & Silpa-archa, N. (2019). Late-onset hepatoerythropoietic porphyria presenting with facial deformities and erythrodontia. Thai Journal of Dermatology, 35(2), 73–80. Retrieved from https://he02.tci-thaijo.org/index.php/TJD/article/view/197522

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Section

Case Report