These are clinically indistinguishable from the skin lesions of porphyria cutanea tarda. The remainder have either acute porphyria by itself, resembling AIP or acute porphyria with skin lesions. 3 Hereditary coproporphyria combines the clinical features of acute and cutaneous porphyria. It is less common than the two other acute porphyrias. These include gastrointestinal symptoms.
Abdominal pain is often very severe.
Constipation and vomiting may also be present. Cardiovascular features occur in 70 per cent of cases and include hypertension and tachycardia. Hypertension may occasionally persist during remission and require treatment. Neuropathy can occur but complicates less than 20 per cent of attacks. Upper limbs and proximal muscles are worst affected and truncal muscle paralysis may lead to respiratory paralysis.