heme-arginate and Crohn-Disease

In the course of four weeks, tetraparesis developed in a 28-year-old man with Crohn's disease for the last six years, treated with glucocorticoids and sulphasalazine. The cause was acute intermittent porphyria which had been previously overlooked because of the similar abdominal symptoms of Crohn's disease. Treatment with glucose, propranolol and haemarginate failed to bring about any improvement, but there was a remission of the porphyria. This case demonstrates that diagnosis of acute intermittent porphyria in the presence of Crohn's disease is difficult, and if delayed therapeutic measures in the face of persisting neurological complications are of little benefit.

Topics: Acute Disease; Adult; Arginine; Crohn Disease; Diagnosis, Differential; Drug Therapy, Combination; Glucose; Heme; Humans; Male; Porphyrias; Propranolol; Quadriplegia; Remission Induction