Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria

Background: Acute hepatic porphyrias (AHPs) represent inherited metabolic disorders of the heme biosynthesis pathway, leading to neurological and systemic impairment. Despite the presence of well-recognized chronic symptoms and signs, acute neurological, both neuromuscular and central neurological c...

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Main Authors: Bruno de Mattos Lombardi Badia, Paulo de Lima Serrano, João Paulo Barile, Daniel Delgado Seneor, Patrícia Marques Mendes, Renan Brandão Rambaldi Cavalheiro, Kaliny Oliveira Peixoto, Igor Braga Farias, Roberta Ismael Lacerda Machado, Wladimir Bocca Vieira de Rezende Pinto, Acary Souza Bulle Oliveira, Paulo Sgobbi
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Language:English
Published: MDPI AG 2025-02-01
Series:Metabolites
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Online Access:https://www.mdpi.com/2218-1989/15/2/99
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author Bruno de Mattos Lombardi Badia
Paulo de Lima Serrano
João Paulo Barile
Daniel Delgado Seneor
Patrícia Marques Mendes
Renan Brandão Rambaldi Cavalheiro
Kaliny Oliveira Peixoto
Igor Braga Farias
Roberta Ismael Lacerda Machado
Wladimir Bocca Vieira de Rezende Pinto
Acary Souza Bulle Oliveira
Paulo Sgobbi
author_facet Bruno de Mattos Lombardi Badia
Paulo de Lima Serrano
João Paulo Barile
Daniel Delgado Seneor
Patrícia Marques Mendes
Renan Brandão Rambaldi Cavalheiro
Kaliny Oliveira Peixoto
Igor Braga Farias
Roberta Ismael Lacerda Machado
Wladimir Bocca Vieira de Rezende Pinto
Acary Souza Bulle Oliveira
Paulo Sgobbi
author_sort Bruno de Mattos Lombardi Badia
collection DOAJ
description Background: Acute hepatic porphyrias (AHPs) represent inherited metabolic disorders of the heme biosynthesis pathway, leading to neurological and systemic impairment. Despite the presence of well-recognized chronic symptoms and signs, acute neurological, both neuromuscular and central neurological complications pose a significant challenge in clinical practice, with a potential risk of greater severity and mortality during acute decompensation episodes of AHPs. Care related to the prescription of medications, considering the risk of porphyrinogenicity, is a major and recurring concern in the acute and chronic management of AHP patients. Infectious clinical complications are significant issues in both outpatient and hospital settings for patients with AHPs. It is crucial to identify therapeutic regimens with the best safety and efficacy profiles for treating such infectious complications in AHP patients. The scarcity of structured knowledge available in guidelines and recommendations often leads to the use of therapeutic options with higher potential risks in treating patients with AHPs. Objectives: This review article aims to provide practical recommendations for managing the most significant infectious complications in clinical practice, with a focus on their impact on the clinical care of patients with AHPs.
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spelling doaj-art-ac31dd762adc44caab715d156ee680bc2025-08-20T03:12:05ZengMDPI AGMetabolites2218-19892025-02-011529910.3390/metabo15020099Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic PorphyriaBruno de Mattos Lombardi Badia0Paulo de Lima Serrano1João Paulo Barile2Daniel Delgado Seneor3Patrícia Marques Mendes4Renan Brandão Rambaldi Cavalheiro5Kaliny Oliveira Peixoto6Igor Braga Farias7Roberta Ismael Lacerda Machado8Wladimir Bocca Vieira de Rezende Pinto9Acary Souza Bulle Oliveira10Paulo Sgobbi11Division of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilDivision of Neuromuscular Diseases, Porphyria Unit, Federal University of São Paulo (UNIFESP), São Paulo 04039-060, SP, BrazilBackground: Acute hepatic porphyrias (AHPs) represent inherited metabolic disorders of the heme biosynthesis pathway, leading to neurological and systemic impairment. Despite the presence of well-recognized chronic symptoms and signs, acute neurological, both neuromuscular and central neurological complications pose a significant challenge in clinical practice, with a potential risk of greater severity and mortality during acute decompensation episodes of AHPs. Care related to the prescription of medications, considering the risk of porphyrinogenicity, is a major and recurring concern in the acute and chronic management of AHP patients. Infectious clinical complications are significant issues in both outpatient and hospital settings for patients with AHPs. It is crucial to identify therapeutic regimens with the best safety and efficacy profiles for treating such infectious complications in AHP patients. The scarcity of structured knowledge available in guidelines and recommendations often leads to the use of therapeutic options with higher potential risks in treating patients with AHPs. Objectives: This review article aims to provide practical recommendations for managing the most significant infectious complications in clinical practice, with a focus on their impact on the clinical care of patients with AHPs.https://www.mdpi.com/2218-1989/15/2/99acute hepatic porphyriainfectious disease medicineanti-infective agentsporphyrinsacute intermittent porphyria
spellingShingle Bruno de Mattos Lombardi Badia
Paulo de Lima Serrano
João Paulo Barile
Daniel Delgado Seneor
Patrícia Marques Mendes
Renan Brandão Rambaldi Cavalheiro
Kaliny Oliveira Peixoto
Igor Braga Farias
Roberta Ismael Lacerda Machado
Wladimir Bocca Vieira de Rezende Pinto
Acary Souza Bulle Oliveira
Paulo Sgobbi
Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria
Metabolites
acute hepatic porphyria
infectious disease medicine
anti-infective agents
porphyrins
acute intermittent porphyria
title Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria
title_full Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria
title_fullStr Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria
title_full_unstemmed Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria
title_short Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria
title_sort practical recommendations in the treatment of acute and chronic life threatening infectious diseases in patients with acute hepatic porphyria
topic acute hepatic porphyria
infectious disease medicine
anti-infective agents
porphyrins
acute intermittent porphyria
url https://www.mdpi.com/2218-1989/15/2/99
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