Thanks for that interesting clinical query. Can you tell us how much exactly
was the leucocyte count and give us a bit more of his follow up?Rakesh
Biswas MD, Asstt Prof, Dept of Medicine,
Manipal Teaching Hospital, Pokhara
Pin-33701, Nepal, phone 009776126416-20-extn 189,Fax-00977-61-27862
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----- Original Message -----
From: Matt Williams <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, April 30, 2002 7:39 PM
Subject: Diagnosis in the face of Porphyria
> Dear List,
>
> A brief, and very clincially based question
>
> 59 yr old man with CRF and minimal renal function and a known history of
> Acute Intermittent Porphyria
>
> In ITU post-op. Complaining of some abdo pain (although has
Tracheostomy,so
> can't really talk).
>
> Apyrexial
> BP stable
> White Cell count rising
> C Reactive Protein lowish (10-20)
> Erythrocyte sedimentation rate approx. = 15
>
> Is this man septic, or is he having a prophyric crisis?
>
> No Urine means nothing for Urinary PBG; Can't do tests on serum
apparently,
> and the filtrate from the haemofilter contains stuff at the same
> concentration as serum.
>
> Any bright ideas ?
>
> Matt Williams
> ITU SHO
> Charing Cross Hospital
>
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