Administration of oral activated charcoal in variegate porphyria results in a paradoxical clinical and biochemical deterioration

Abstract

Oral charcoal administration results in a paradoxical aggravation of VP, suggesting a complex and as yet undefined interaction of hepatic porphyrin metabolism and bowel porphyrin reabsorption. Oral sorbents should not be prescribed to subjects with VP.

Oral cholestyramine is not an effective treatment for uncomplicated erythropoietic protoporphyria

“…Few studies have addressed this issue, and among those conducted, the results are limited in scope. [1][2][3][4][5] Interestingly, despite changes in…”

“…2 Activated charcoal, an alternative porphyrin chelator, has also been tried in EPP, 3 although it has no effect in patients with congenital erythropoietic porphyria(CEP) 4 and causes a paradoxical clinical and biochemical deterioration in variegate porphyria. 5 The absence of effective treatment for EPP makes it important to establish whether a treatment such as cholestyramine is effective or not. Since red cell and plasma protoporphyrin concentrations are the pathologically relevant measures, we assayed these in 3 EPP patients before, during, and after treatment with oral cholestyramine.…”