Differentials
Other conditions that cause abdominal pain
SIGNS / SYMPTOMS
AIP symptoms are neurologic rather than inflammatory, so peritoneal signs, fever, and leukocytosis are usually not as prominent as in other abdominal conditions.
INVESTIGATIONS
CBC to eliminate leukocytosis.
Substantial increase of urinary porphobilinogen confirms porphyria.
Delta-aminolevulinate dehydratase deficiency porphyria
SIGNS / SYMPTOMS
Symptoms similar to AIP but extremely rare condition.[21]
INVESTIGATIONS
Delta-aminolevulinic acid and coproporphyrin III are markedly increased in urine, and porphobilinogen is normal or slightly increased. Erythrocyte zinc protoporphyrin is also markedly increased.
Hereditary coproporphyria
SIGNS / SYMPTOMS
Presentation the same as AIP, but occasionally associated with blistering skin lesions.
INVESTIGATIONS
Fecal total porphyrins are substantially increased with a marked, usually isolated increase in fecal coproporphyrin III by high-performance liquid chromatography.[18]
Variegate porphyria
SIGNS / SYMPTOMS
May present as in AIP but often associated with blistering skin lesions.
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