BMJ Case Reports 2016; doi:10.1136/bcr-2016-215350

Acute intermittent porphyria leading to posterior reversible encephalopathy syndrome (PRES): a rare cause of abdominal pain and seizures

  1. Michael James Gilhooley2
  1. 1Department of Acute Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  2. 2Department of Acute Medicine, Moorfields Eye Hospital, London, UK
  1. Correspondence to Dr Andrew Dagens, drewdagens{at}
  • Accepted 22 May 2016
  • Published 8 June 2016


Acute intermittent porphyria (AIP) is an inherited deficiency in the haem biosynthesis pathway. AIP is rare, affecting around 1 in 75 000 people. Acute attacks are characterised by abdominal pain associated with autonomic, neurological and psychiatric symptoms. AIP is rarely associated with posterior reversible encephalopathy syndrome (PRES). PRES is a clinicoradiological condition caused by the failure of the posterior circulation to autoregulate, resulting in cerebral oedema, headaches, nausea and seizures. This association is important because drugs used in the management of seizures may worsen an attack of AIP. This article describes a case of AIP and PRES in a young woman.

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