4.6 Review

Laboratory Diagnosis of Porphyria

Journal

DIAGNOSTICS
Volume 11, Issue 8, Pages -

Publisher

MDPI
DOI: 10.3390/diagnostics11081343

Keywords

porphyria; ALA (5-aminolevulinic acid); PBG (porphobilinogen); porphyrins; HPLC (high-pressure liquid chromatography); MLPA (multiplex ligation-dependent probe amplification); NGS (next-generation sequencing); EPNET (European Porphyria Network); diagnosis

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Porphyrias are a group of clinically and genetically heterogeneous diseases originating mostly from inherited dysfunctions of specific enzymes involved in heme biosynthesis. Laboratory diagnosis can support clinical suspicion in symptomatic patients, and enzymatic activities measurement along with molecular analysis may confirm the diagnosis.
Porphyrias are a group of diseases that are clinically and genetically heterogeneous and originate mostly from inherited dysfunctions of specific enzymes involved in heme biosynthesis. Such dysfunctions result in the excessive production and excretion of the intermediates of the heme biosynthesis pathway in the blood, urine, or feces, and these intermediates are responsible for specific clinical presentations. Porphyrias continue to be underdiagnosed, although laboratory diagnosis based on the measurement of metabolites could be utilized to support clinical suspicion in all symptomatic patients. Moreover, the measurement of enzymatic activities along with a molecular analysis may confirm the diagnosis and are, therefore, crucial for identifying pre-symptomatic carriers. The present review provides an overview of the laboratory assays used most commonly for establishing the diagnosis of porphyria. This would assist the clinicians in prescribing appropriate diagnostic testing and interpreting the testing results.

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