Erythropoietic protoporphyria: case reports for clinical and therapeutic hints

Abstract Background Erythropoietic protoporphyria is a rare disorder which represents an important health problem in children, causing painful photosensitivity. Little is known on the correlation between genetic profile and clinical manifestations. The standard of care for Erythropoietic protoporphy...

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Main Authors: Cristina Tumminelli, Francesca Burlo, Serena Pastore, Giovanni Maria Severini, Irene Berti, Stefano Marchini, Davide Zanon, Eleonora De Martino, Alberto Tommasini
Format: Article
Language:English
Published: BMC 2023-11-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-023-01544-2
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author Cristina Tumminelli
Francesca Burlo
Serena Pastore
Giovanni Maria Severini
Irene Berti
Stefano Marchini
Davide Zanon
Eleonora De Martino
Alberto Tommasini
author_facet Cristina Tumminelli
Francesca Burlo
Serena Pastore
Giovanni Maria Severini
Irene Berti
Stefano Marchini
Davide Zanon
Eleonora De Martino
Alberto Tommasini
author_sort Cristina Tumminelli
collection DOAJ
description Abstract Background Erythropoietic protoporphyria is a rare disorder which represents an important health problem in children, causing painful photosensitivity. Little is known on the correlation between genetic profile and clinical manifestations. The standard of care for Erythropoietic protoporphyria is based on avoiding sun and using sun protections, but recent literature has suggested that cimetidine may have a role in improving sun sensitivity. Herein we report our case series describing the successful use of cimetidine and analyzing potential phenotype-genotype correlations. Case presentation This case series describes five patients presented to our Rheumatology Service complaining sun sensitivity. Blood exams and genetic analysis were consistent with the diagnosis of erythropoietic protoporphyria. Four of 5 patients received cimetidine in addition to standard therapies and the effect of treatment was evaluated by Erythropoietic Protoporphyria - Quality of Life questionnaire. Conclusions Erythropoietic protoporphyria usually manifests in early childhood after a short sun exposure. Skin manifestations are the main reason for investigations, although sometimes they can be more subtle, leading to a significant diagnostic delay. Skin diseases in children can have profound effects on their family and social relationships. A treatment with cimetidine appears to be an excellent therapeutic option in children with Erythropoietic protoporphyria.
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spelling doaj-art-247823627b9848d68af62a09fdff36f02025-08-20T01:57:16ZengBMCItalian Journal of Pediatrics1824-72882023-11-014911510.1186/s13052-023-01544-2Erythropoietic protoporphyria: case reports for clinical and therapeutic hintsCristina Tumminelli0Francesca Burlo1Serena Pastore2Giovanni Maria Severini3Irene Berti4Stefano Marchini5Davide Zanon6Eleonora De Martino7Alberto Tommasini8Department of Medicine, Surgery, and Health Sciences, University of TriesteDepartment of Medicine, Surgery, and Health Sciences, University of TriesteDepartment of Pediatrics, Institute for Maternal and Child Health “IRCCS Burlo Garofolo”Department of Medical Genetics, Institute for Maternal and Child Health, IRCCS Burlo GarofoloDepartment of Pediatrics, Institute for Maternal and Child Health “IRCCS Burlo Garofolo”Department of Surgical and Medical Sciences for Children and Adults, Internal Medicine Unit, University of Modena and Reggio EmiliaPharmacy and Clinical Pharmacology Department, Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”Department of Pediatrics, Institute for Maternal and Child Health “IRCCS Burlo Garofolo”Department of Medicine, Surgery, and Health Sciences, University of TriesteAbstract Background Erythropoietic protoporphyria is a rare disorder which represents an important health problem in children, causing painful photosensitivity. Little is known on the correlation between genetic profile and clinical manifestations. The standard of care for Erythropoietic protoporphyria is based on avoiding sun and using sun protections, but recent literature has suggested that cimetidine may have a role in improving sun sensitivity. Herein we report our case series describing the successful use of cimetidine and analyzing potential phenotype-genotype correlations. Case presentation This case series describes five patients presented to our Rheumatology Service complaining sun sensitivity. Blood exams and genetic analysis were consistent with the diagnosis of erythropoietic protoporphyria. Four of 5 patients received cimetidine in addition to standard therapies and the effect of treatment was evaluated by Erythropoietic Protoporphyria - Quality of Life questionnaire. Conclusions Erythropoietic protoporphyria usually manifests in early childhood after a short sun exposure. Skin manifestations are the main reason for investigations, although sometimes they can be more subtle, leading to a significant diagnostic delay. Skin diseases in children can have profound effects on their family and social relationships. A treatment with cimetidine appears to be an excellent therapeutic option in children with Erythropoietic protoporphyria.https://doi.org/10.1186/s13052-023-01544-2PorphyriaPhotosensitivityCimetidineChildren porphyriaFerrochelatase gene
spellingShingle Cristina Tumminelli
Francesca Burlo
Serena Pastore
Giovanni Maria Severini
Irene Berti
Stefano Marchini
Davide Zanon
Eleonora De Martino
Alberto Tommasini
Erythropoietic protoporphyria: case reports for clinical and therapeutic hints
Italian Journal of Pediatrics
Porphyria
Photosensitivity
Cimetidine
Children porphyria
Ferrochelatase gene
title Erythropoietic protoporphyria: case reports for clinical and therapeutic hints
title_full Erythropoietic protoporphyria: case reports for clinical and therapeutic hints
title_fullStr Erythropoietic protoporphyria: case reports for clinical and therapeutic hints
title_full_unstemmed Erythropoietic protoporphyria: case reports for clinical and therapeutic hints
title_short Erythropoietic protoporphyria: case reports for clinical and therapeutic hints
title_sort erythropoietic protoporphyria case reports for clinical and therapeutic hints
topic Porphyria
Photosensitivity
Cimetidine
Children porphyria
Ferrochelatase gene
url https://doi.org/10.1186/s13052-023-01544-2
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