[Download] ~ Acute Attack of AIP (Acute Intermittent Porphyria) with Severe Vivax Malaria Associated with Convulsions: A Case Report (Case Reports) (Case Study) # by Journal of Vector Borne Diseases ~ eBook PDF Kindle ePub Free
eBook details
- Title: Acute Attack of AIP (Acute Intermittent Porphyria) with Severe Vivax Malaria Associated with Convulsions: A Case Report (Case Reports) (Case Study)
- Author : Journal of Vector Borne Diseases
- Release Date : January 01, 2009
- Genre: Health & Fitness,Books,Health, Mind & Body,
- Pages : * pages
- Size : 85 KB
Description
Acute intermittent porphyria (AIP) is a hereditary hepatic porphyria inherited as autosomal dominant with low penetrance resulting from mutation in the gene encoding the enzyme, porphobilinogen deaminase (PBG-D) [hydroxymethylbilane synthase, uroporphyrinogen I synthase]. The diagnosis is often obscured by the variable presentation, viz. abdominal pain (commonest), constipation, vomiting, convulsions, and peripheral neuropathy and further complicated by the variable course of illness. Incidence of convulsions is 10-20% but there may be presenting symptom of an acute relapse (1,2). Although Plasmodium vivax usually causes benign uncomplicated malaria, it can occasionally result in severe disease with life-threatening, end-organ involvement including cerebral malaria manifesting as convulsions (3). This case is a rare presentation of severe vivax malaria and exemplifies the dilemma associated with diagnosis and treatment of convulsions when it occurs in a case of AIP. This case underscores the importance of considering the safety profile of antimalarials and anticonvulsants in a case of AIP. Case report: A 19-year old unmarried female patient presented with low grade continuous fever associated with chills and rigors of two weeks duration and altered consciousness (EMV score--6/15) for the last three hours following an attack of generalized tonic clonic convulsions. There was no history of headache, pain in the abdomen, decreased appetite or vomiting, however, the patient was passing red colour urine and having severe constipation. She was having past history of recurrent attacks of abdominal pain and passing red colour urine since last five years for which she was diagnosed as a case of AIP. The clinical examination revealed palpable liver and spleen. The detailed neurological examination did not reveal any finding except unarousable coma and bilateral extensor planter response.
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