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Clin Biochem
. 2025 Oct 15:111023.
doi: 10.1016/j.clinbiochem.2025.111023. Online ahead of print. HFE related acute porphyria-like attack induced by severe influenza A pneumonia
Hongmei Yang 1 , Jianxing Guo 1 , Guowei Ye 1 , Dongxia Wang 1 , Yimin Yang 2
Affiliations
This case report describes a patient with HFE-related acute porphyria-like attack triggered by severe influenza A pneumonia. The patient was admitted with fever, dyspnea, and abdominal pain and was diagnosed with severe influenza A pneumonia, acute respiratory failure, and septic shock. On the third day of hospitalization, the patient developed profound shock requiring mechanical ventilation and tested positive for influenza A virus. During treatment, significant liver dysfunction was observed, along with clinical manifestations including abdominal pain, loss of consciousness, and bilateral strabismus, suggesting neurological involvement. The diagnosis of acute porphyria-like attack was confirmed by positive urine porphobilinogen testing and genetic detection of a HFEH63D mutation. This case highlights the importance of maintaining a high index of suspicion for porphyrin metabolism dysfunction in critically ill patients, particularly in the setting of infection or other precipitating factors. Timely diagnosis and management can significantly improve patient outcomes. These findings provide new insights into the clinical recognition of porphyria, especially in critically ill patients, and underscore the importance of multidisciplinary collaboration and meticulous diagnostic evaluation.
Keywords: Acute porphyria-like attack; HFE gene mutation; Neurological symptoms; Severe influenza A pneumonia.
. 2025 Oct 15:111023.
doi: 10.1016/j.clinbiochem.2025.111023. Online ahead of print. HFE related acute porphyria-like attack induced by severe influenza A pneumonia
Hongmei Yang 1 , Jianxing Guo 1 , Guowei Ye 1 , Dongxia Wang 1 , Yimin Yang 2
Affiliations
- PMID: 41106535
- DOI: 10.1016/j.clinbiochem.2025.111023
This case report describes a patient with HFE-related acute porphyria-like attack triggered by severe influenza A pneumonia. The patient was admitted with fever, dyspnea, and abdominal pain and was diagnosed with severe influenza A pneumonia, acute respiratory failure, and septic shock. On the third day of hospitalization, the patient developed profound shock requiring mechanical ventilation and tested positive for influenza A virus. During treatment, significant liver dysfunction was observed, along with clinical manifestations including abdominal pain, loss of consciousness, and bilateral strabismus, suggesting neurological involvement. The diagnosis of acute porphyria-like attack was confirmed by positive urine porphobilinogen testing and genetic detection of a HFEH63D mutation. This case highlights the importance of maintaining a high index of suspicion for porphyrin metabolism dysfunction in critically ill patients, particularly in the setting of infection or other precipitating factors. Timely diagnosis and management can significantly improve patient outcomes. These findings provide new insights into the clinical recognition of porphyria, especially in critically ill patients, and underscore the importance of multidisciplinary collaboration and meticulous diagnostic evaluation.
Keywords: Acute porphyria-like attack; HFE gene mutation; Neurological symptoms; Severe influenza A pneumonia.