RT Journal Article SR Electronic T1 Acute intermittent porphyria: fatal complications of treatment JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 293 OP 294 DO 10.7861/clinmedicine.12-3-293 VO 12 IS 3 A1 PE Stein A1 MN Badminton A1 JH Barth A1 DC Rees A1 R Sarkany A1 MF Stewart A1 TM Cox YR 2012 UL http://www.rcpjournals.org/content/12/3/293.abstract AB Acute neurovisceral attacks of porphyria can be life threatening. They are rare and notoriously difficult to diagnose clinically, but should be considered, particularly in female patients with unexplained abdominal pain, and associated neurological or psychiatric features or hyponatraemia. The diagnosis might be suggested by altered urine colour and can be confirmed by finding an elevated porphobilinogen concentration in fresh urine protected from light. Severe attacks require treatment with intravenous haem arginate and supportive management with safe drugs, including adequate analgesia. Intravenous glucose in water solutions are contraindicated as they aggravate hyponatraemia, which can prove fatal.