SODIUM AND CHLORIDE DEPLETION IN ACUTE PORPHYRIA WITH REFERENCE TO THE STATUS OF ADRENAL CORTICAL FUNCTION

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Abstract
A study has been made of the conditions associated with sodium and chloride deficiency in a case of acute porphyria. In an attempt to elucidate whether or not this was due to adrenal cortical damage it was shown that the admn. of DCA, 10 mg. intramuscularly, brought about no improvement in the electrolyte metabolism and the indications were that endogenous DCA-like secretion was unimpaired. Tests of adrenal cortical function with ACTH showed this to be adequate. Histological study of material from 3 other cases suggested a good adrenal cortical reaction to the "stress" imposed in this disease and examination of the kidneys revealed changes of the type of the so-called "lower nephron nephrosis" of Lucke. It seemed possible that the disordered electrolyte metabolism was associated with renal tubular changes.