Eine 25-jährige Patientin mit Pseudoobstruktion des Kolons, Hyponatriämie, hypertensiver Entgleisung und diffusem Schmerzsyndrom

Philipp Lutz; Daniel Maring; Henriette J Tschampa; Tilman Sauerbruch

doi:10.1007/s00063-010-1047-1

Eine 25-jährige Patientin mit Pseudoobstruktion des Kolons, Hyponatriämie, hypertensiver Entgleisung und diffusem Schmerzsyndrom

Translated title of the contribution: A 25-year-old patient with colonic pseudo-obstruction, hyponatremia, hypertension, and diffuse pain

Philipp Lutz, Daniel Maring, Henriette J Tschampa, Tilman Sauerbruch

Immunology and Immunotherapy

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

CASE REPORT: A 25-year-old hypertensive patient presented to the Emergency Department with constipation and diffuse pain which had been increasing for 10 days. She had consulted several doctors before, but neither various analgesics nor metoclopramide had been beneficial. Blood analysis showed hyponatremia. A megacolon and polyneuropathy were found. Shortly after admission, she developed generalized seizures while hyponatremia increased compatible with SIADH (syndrome of inadequate ADH secretion). Urine examination revealed a markedly elevated excretion of porphyrins. Since porphobilinogen deaminase activity was clearly decreased, diagnosis of acute intermittent porphyria could be confirmed.

CONCLUSION: This case shows how definite diagnosis of this illness is often delayed because of its rarity and the variety of its possible symptoms and signs. This delay leads to a high risk of aggravating the disease by prescribing porphyrinogenic drugs.

Translated title of the contribution	A 25-year-old patient with colonic pseudo-obstruction, hyponatremia, hypertension, and diffuse pain
Original language	German
Pages (from-to)	267-72
Number of pages	6
Journal	Medizinische Klinik
Volume	105
Issue number	4
DOIs	https://doi.org/10.1007/s00063-010-1047-1
Publication status	Published - Apr 2010

Keywords

Adult
Colonic Pseudo-Obstruction
Delayed Diagnosis
Diagnosis, Differential
Epilepsy, Generalized
Female
Humans
Hydroxymethylbilane Synthase
Hypertension
Hyponatremia
Inappropriate ADH Syndrome
Pain
Porphyria, Acute Intermittent

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10.1007/s00063-010-1047-1

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title = "Eine 25-j{\"a}hrige Patientin mit Pseudoobstruktion des Kolons, Hyponatri{\"a}mie, hypertensiver Entgleisung und diffusem Schmerzsyndrom",

abstract = "CASE REPORT: A 25-year-old hypertensive patient presented to the Emergency Department with constipation and diffuse pain which had been increasing for 10 days. She had consulted several doctors before, but neither various analgesics nor metoclopramide had been beneficial. Blood analysis showed hyponatremia. A megacolon and polyneuropathy were found. Shortly after admission, she developed generalized seizures while hyponatremia increased compatible with SIADH (syndrome of inadequate ADH secretion). Urine examination revealed a markedly elevated excretion of porphyrins. Since porphobilinogen deaminase activity was clearly decreased, diagnosis of acute intermittent porphyria could be confirmed.CONCLUSION: This case shows how definite diagnosis of this illness is often delayed because of its rarity and the variety of its possible symptoms and signs. This delay leads to a high risk of aggravating the disease by prescribing porphyrinogenic drugs.",

keywords = "Adult, Colonic Pseudo-Obstruction, Delayed Diagnosis, Diagnosis, Differential, Epilepsy, Generalized, Female, Humans, Hydroxymethylbilane Synthase, Hypertension, Hyponatremia, Inappropriate ADH Syndrome, Pain, Porphyria, Acute Intermittent",

author = "Philipp Lutz and Daniel Maring and Tschampa, {Henriette J} and Tilman Sauerbruch",

year = "2010",

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doi = "10.1007/s00063-010-1047-1",

language = "German",

volume = "105",

pages = "267--72",

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T1 - Eine 25-jährige Patientin mit Pseudoobstruktion des Kolons, Hyponatriämie, hypertensiver Entgleisung und diffusem Schmerzsyndrom

AU - Lutz, Philipp

AU - Maring, Daniel

AU - Tschampa, Henriette J

AU - Sauerbruch, Tilman

PY - 2010/4

Y1 - 2010/4

N2 - CASE REPORT: A 25-year-old hypertensive patient presented to the Emergency Department with constipation and diffuse pain which had been increasing for 10 days. She had consulted several doctors before, but neither various analgesics nor metoclopramide had been beneficial. Blood analysis showed hyponatremia. A megacolon and polyneuropathy were found. Shortly after admission, she developed generalized seizures while hyponatremia increased compatible with SIADH (syndrome of inadequate ADH secretion). Urine examination revealed a markedly elevated excretion of porphyrins. Since porphobilinogen deaminase activity was clearly decreased, diagnosis of acute intermittent porphyria could be confirmed.CONCLUSION: This case shows how definite diagnosis of this illness is often delayed because of its rarity and the variety of its possible symptoms and signs. This delay leads to a high risk of aggravating the disease by prescribing porphyrinogenic drugs.

AB - CASE REPORT: A 25-year-old hypertensive patient presented to the Emergency Department with constipation and diffuse pain which had been increasing for 10 days. She had consulted several doctors before, but neither various analgesics nor metoclopramide had been beneficial. Blood analysis showed hyponatremia. A megacolon and polyneuropathy were found. Shortly after admission, she developed generalized seizures while hyponatremia increased compatible with SIADH (syndrome of inadequate ADH secretion). Urine examination revealed a markedly elevated excretion of porphyrins. Since porphobilinogen deaminase activity was clearly decreased, diagnosis of acute intermittent porphyria could be confirmed.CONCLUSION: This case shows how definite diagnosis of this illness is often delayed because of its rarity and the variety of its possible symptoms and signs. This delay leads to a high risk of aggravating the disease by prescribing porphyrinogenic drugs.

KW - Adult

KW - Colonic Pseudo-Obstruction

KW - Delayed Diagnosis

KW - Diagnosis, Differential

KW - Epilepsy, Generalized

KW - Female

KW - Humans

KW - Hydroxymethylbilane Synthase

KW - Hypertension

KW - Hyponatremia

KW - Inappropriate ADH Syndrome

KW - Pain

KW - Porphyria, Acute Intermittent

U2 - 10.1007/s00063-010-1047-1

DO - 10.1007/s00063-010-1047-1

M3 - Article

C2 - 20455047

SN - 0723-5003

VL - 105

SP - 267

EP - 272

JO - Medizinische Klinik

JF - Medizinische Klinik

IS - 4

ER -

Eine 25-jährige Patientin mit Pseudoobstruktion des Kolons, Hyponatriämie, hypertensiver Entgleisung und diffusem Schmerzsyndrom

Abstract

Keywords

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