THE TREATMENT OF ACUTE PORPHYRIA WITH CHELATING AGENTS: A REPORT OF 21 CASES

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Abstract
Symptomatology of 25 porphyria cases is summarized. Evidence strongly suggested the favorable effect of chelation in 14 of 21 acute porphyria patients, including one case of hepatic mixed porphyria. 2,3-Dimercaptopropanol (BAL) and ethylenediaminetetraacetate (EDTA) are both effective, although in the dosage employed BAL seemed to act more rapidly. Renal failure appearing in acute porphyria with or without chelation may be reversed by hydrocortisone and does not recur with additional BAL or EDTA therapy. Chelation may be effective after failure with ACTH, and vice versa. All cases must avoid exposure to barbiturates, sulfonamide, heavy metals, oil paints and solvents. Elevation of Zn urine excretion is noted during acute episodes preceding chelation and parallels the symptoms more closely than abnormal porphyrin excretion.