less than 60 cases of erythropoietic porphyria have been described since the original report by Shultz in 1874. It is a congenital disease and is generally thought to be transmitted in a non sex‐linked recessive mode (Goldberg and Rimington, 1962, p. 49; Heilmeyer, Clotten, Kerp, Merker, Parra and Wetzel, 1964). All cases in whom a definitive statement was made regarding age of onset presented in childhood and no patient has survived to middle age (Goldberg and Rimington, 1962, p. 55). The first of the two cases described here is unusual in that the disease only manifested itself after the age of 50
Most patients with erythropoietic porphyria have a haemolytic anaemia (Goldberg and Rimington, 1962, p. 54). There is frequently a reticulocytosis and the serum bilirubin may be slightly raised. Urobilinogen and stercobilinogen excretion are increased. Erythrocyte survival has been studied in a few cases with equivocal results (London, West, Shemin and Rittenburg, 1950; Gray, Muir and Neuberger, 1950; Rosenthal, Lipton and Asrow, 1955; Canivet and Pernard‐Considére, 1958; Heilmeyer et al., 1964). In an attempt to elucidate the mechanism underlying the anaemia associated with this disease two cases of erythropoietic porphyria were studied using a combined radioactive iron and chromium technique to make detailed simultaneous measurements of red‐cell production and destruction.