Hydroxymethylbilane Synthase Gene Mutation: The Hidden Driver of Abdominal Pain and Neurological Symptoms in Acute Intermittent Porphyria

Autor: Abeer Zakariyah, Rahaf Alzahrani, Iman Alhazmi, Alia Abotaleb, Mohammed Alasmari, Abdulrahim Basendwah, Rasha Alsubaie, Muhammad Sohaib Khan, Leena Alnajjar, Sultan Altouri
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Applied Hematology, Vol 15, Iss 2, Pp 147-151 (2024)
Druh dokumentu: article
ISSN: 1658-5127
2454-6976
DOI: 10.4103/joah.joah_19_24
Popis: Mutations in the hydroxymethylbilane synthase (HMBS) gene can lead to a deficiency of the HMBS enzyme, allowing porphyrins to accumulate to toxic levels in the liver and other organs, leading to acute intermittent porphyria (AIP). This case report describes the medical journey of a 20-year-old female, previously in good health, who experienced multiple hospitalizations and clinic visits due to severe abdominal pain episodes and remained undiagnosed for over 6 years. Despite the nonspecific nature of these symptoms, a suspicion of acute porphyria confirmed by genetic analysis revealed a splice pathogenic variant (c.826-2A>T) in the HMBS gene in a heterozygous state. As the disease progressed, the patient developed a series of complications, including hyponatremia, autonomic instability, and motor neuropathy, culminating in complete paralysis (quadriplegia) and respiratory failure. The case highlights the importance of early recognition and differential diagnoses in managing AIP, with genetic testing playing a crucial role in confirming the diagnosis.
Databáze: Directory of Open Access Journals