A 23-year-old woman presents to the emergency department with severe colicky abdominal pain, anxiety, and acute proximal arm and leg weakness. Vital signs show BP 148/92 mmHg, HR 102/min, RR 18/min, Temp 37.2°C. She recently started phenobarbital for insomnia. Urine is dark red and darkens further on standing. Serum sodium is 128 mEq/L. Cranial nerves and sensation remain intact. Which of the following best explains her weakness?
- A)Demyelination caused by Campylobacter infection
- B)Inherited absence of dystrophin
- C)Acute motor neuropathy due to porphyrin pathway dysfunctionGABARITO
- D)Calcium channel antibodies associated with lung cancer
- E)Autoimmune destruction of neuromuscular junction receptors
Explicação
Acute intermittent porphyria can cause neurovisceral attacks with abdominal pain, psychiatric symptoms, and a predominantly motor neuropathy. Attacks are precipitated by CYP inducing drugs such as barbiturates. Ver explicação completa e trilha adaptativa →