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Recently we have had the opportunity to perform a metabolic study of a young man with an attack of acute intermittent porphyria associated with hyponatrcmia. A detailed report will appear later, but we shall here briefly summarize the results obtained in this study.Pt. E. F. (no. 525/64), an unmarried air-plane steward, with a family history of acute intermittent porphyria was admitted to the surgical department because of pain in the lower left side of the abdomen, constipation, and 2-3 vomiting spells in the course of the preceeding 60 hours. As the diuresis was low (appr. 300 ml per 24 hours), he was induced to drink. 4 days after the admission he was transferred to the neurological department a f t q 3 seizures of universal convulsions. We found a somewhat confused and slightly hallucinated, well-nourished young man who appeared to be normally hydrated. On the day after the transfer, he produced a port-wine coloured urine with a high content of delta-aminolevulinic acid and a smaller amount of porphobilinogen. On day 2 the plasma electrocytes showed the following values: sodium 121 meqil, potassium 4.1 meq/l, chloride 94 meq/l and standard bicarbonate 25.1 meq/l. On day 5 the plasma sodium and chloride concentrations were 118 and 88 meq/l, respectively. The diuresis on the same day was 1500 ml per 24 hours with a specific gravity of 1.019.From day 5 the patient was treated with a reduced fluid intake (day 5-11: 500 ml per 24 hours) and a sodium intake of about 150 meq per 24 hours. The psychiatric symptoms faded away, and no further convulsions were observed.On day 9 and 10, in a moment of deficient observation, the patient's thirst forced him to drink freely. A few hours later h e was more confused, hallucinated, and the physical examination showed a reduced ability to raise the legs. After the vigorous regimen of fluid restriction had been reestablished, the symptoms rapidly disappeared. The fluid intake was gradually increased, and the further course was uneventful. The patient was discharged on the 36th day.-A slight proteinuria was present on admission, but otherwise renal and suprarenal functions appeared to be normal.Bioassays for antidiuretic material in the urine from days 11 and 12 were performed in trained, hydrated dogs. The daily urinary excretion of antidiuretic ma-Received February 27th 1964 from the Neurological Department, The Municipal Hospital, Copenhagen and the Institute of Medical Physiology, University of C,openhagen.

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