Martínez VCA, Quintero GMA

Language: Spanish
References: 11
Page: 214-217
PDF size: 201.61 Kb.

ABSTRACT

Porphyria is a metabolic disorder that affects the biosynthesis of the heme group, resulting in different clinical manifestations. It usually occurs by inheritance of a mutation in the genes that encode these enzymes, its inheritance pattern is autosomal dominant with low penetrance, from which different types of porphyria are derived: acute intermittent porphyria, hereditary coproporphyria, variegate porphyria, porphyria cutanea tarda. The most common variety is acute intermittent porphyria. This disease is responsible for a wide variety of symptoms, all secondary to nervous system affection. Amongst the most common symptoms affecting people with porphyria, we have pain. The pain presented in porphyria is predominantly neuropathic so pain management should be focused on this. In this article we propose a case report for literature review. In this case it's about a 27-year-old female with acute intermittent porphyria with no other significant medical history, who was admitted to the emergency department due to an abdominal irruptive pain crisis, with intensity 10/10 in numerical analogue scale for pain evaluation. The patient was treated in previous crisis with oxycodone and morphine without adequate response to treatment, in this occasion we decided to use simple lidocaine in a 3-hour duration infusion, calculating the dose at 1.5 mg/kg. Prior to infusion we administered a 1 mg/kg bolus for ten minutes and then the infusion calculated dose for 1.5 mg/kg. After 1.5 hours of lidocaine infusion treatment the patient reports an improvement in pain of more than 50% concerning her initial pain reporting 6/10 intensity in numerical analogue scale for pain evaluation. At the end of the treatment, she reports almost a 100% improvement in pain reporting 1/10 in numerical analogue scale for pain evaluation. Patient was discharged from the emergency department without incidents.

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