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{
    "pk": 1490,
    "title": "Implanted Progestin Causing Pain and Psychiatric Disturbances in Porphyria Attack: A Case Report",
    "subtitle": null,
    "abstract": "<p><b>Introduction: </b>Acute hepatic porphyrias (AHP) are a rare group of inherited disorders caused by abnormal functioning of the heme synthesis pathway. Patients often present with diffuse abdominal pain, neurologic dysfunction, and hyponatremia.&nbsp;</p><p><b>Case Report:</b> We present a case of a 25-year-old female who presented with AHP after implantation&nbsp;</p><p>of progestin birth control. The patient was confused, markedly tachycardic and hypertensive, and complained of severe abdominal pain. Spot urine ordered during the emergency department workup was later found positive for porphyrins and porphobilinogen (PBG).</p><p><b>Conclusion:</b> Acute hepatic porphyrias typically present with nonspecific symptoms in young women and are often overlooked in the acute care setting. Spot urine testing for PBG and urine porphyrins should be initiated early in patients with clinical suspicion of AHP.&nbsp;</p>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "case report; porphyria; hemin; urine porphyrins"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/69m3b7g5",
    "frozenauthors": [
        {
            "first_name": "Ryan",
            "middle_name": "K.",
            "last_name": "Misek",
            "name_suffix": "",
            "institution": "Midwestern University, Chicago College of Osteopathic Medicine, Department of Emergency Medicine, Downers Grove, Illinois",
            "department": ""
        },
        {
            "first_name": "Massimo",
            "middle_name": "F.",
            "last_name": "Riitano",
            "name_suffix": "",
            "institution": "Midwestern University, Chicago College of Osteopathic Medicine, Downers Grove, Illinois",
            "department": ""
        }
    ],
    "date_submitted": "2023-07-03T21:17:01.968000+03:00",
    "date_accepted": "2023-07-03T21:25:13.573000+03:00",
    "date_published": "2023-08-14T19:00:00+03:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1490/galley/1131/download/"
        }
    ]
}