The two most important diagnostic recommendations are to 1) maintain a high index of suspicion, and 2) be aware that laboratory testing is available that can readily make a diagnosis of acute porphyria or rule it out.
The most effective therapy for the acute attack is Panhematin®. This treatment is specific, because it corrects the deficiency of regulatory heme in the liver and down-regulates ALAS. Glucose loading has a similar effect, but is much less potent and effective and should be used only for mild attacks.
Harmful drugs should be stopped immediately and avoided during treatment. For example, metoclopramide should not be given. Information on harmful medications is found at the APF (www.apfdrugdatabase.com) and EPI websites (www.drugs-porphyria.org) as searchable databases that are updated periodically (1).
*Please note that symptoms and treatment of HCP and VP are similar.
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