Diagnostic and Therapeutic Challenges in an Acute Variegate Porphyric Crisis Complicated by Anuric Renal Failure and Multiorgan Dysfunction: A Case Report

26 April 2025 : Case report Australia

Challenging differential diagnosis, Rare disease

Peter B. Conroy^{ABCDEF 1}, Sue Davel^{BCDEF 2}, Jacques A.J. Malherbe

^{BCDEF 3,4}, Simon J. Carrivick^{BCDEF 5}, Edward N. Briggs^{BCDEF 1*}

DOI: 10.12659/AJCR.946969

Am J Case Rep 2025; 26:e946969

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Table 1. Initial blood count parameters obtained on admission to hospital.

Complete blood count			Renal and liver function tests
Parameter	Reference range	Result	Parameter	Reference range	Result
Hb	130–170 g/L	118	Sodium	135–145 mmol/L	126
RCC	Cells×10/L	4.36	Potassium	3.5–5.2 mmol/L	3.8
PCV	N/A	0.343	Chloride	95–110 mmol/L	87
MCHC	320–360 g/L	344	Bicarbonate	22–32 mmol/L	23
MCV	82–100 fL	79	Urea	3.0–8.0 mmol/L	23.4
MCH	pg	27.1	Creatinine	45–90 μmol/L	388
RDW	<16%	13	eGFR	mL/min/1.73 m	9
Platelets	135–370×10/L	99	Bilirubin	<16 μmol/L	78
WCC	Cells×10/L	12.2	ALT	<31 U/L	35
Lymphocytes	1.0–4.0×10/L	0.4	AST	<36 U/L	61
Neutrophils	1.8–7.5×10/L	10.7	ALP	30–110 U/L	211
Eosinophils	<0.7×10/L	0	GGT	<36 U/L	70
Basophils	<0.4×10/L	0	Albumin	36–48 g/L	32
fL – femtolitre; g – grams; Hb – hemoglobin; L – liter; m – meter; MCH – mean cell hemoglobin; MCHC – mean cell hemoglobin concentration; MCV – mean cell volume; min – minute; mL – milliliter; mmol – millimole; PCV – packed cell volume; pg – picogram; RCC – red cell count; RDW – red cell distribution width; U – units; WCC – white cell count; % – percent; μmol – micromole.

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