Could attacks of abdominal pain in cases of acute intermittent porphyria be due to intestinal angina?

Lithner F (Department of Medicine, University Hospital, Umeå, Sweden). Could attacks of abdominal pain in cases of acute intermittent porphyria be due to intestinal angina? J Intern Med 2000; 247 : 407–409. Abdominal pain is by far the most serious symptom in attacks of acute intermittent porphyria. Its cause is unknown. This case study suggests visceral ischaemia as a possible cause of the abdominal pain. A 31‐year‐old woman with recurrent bouts died during an attack; the autopsy revealed a 20‐cm necrotic gangrene in the ileum. A protracted intestinal vasospasm could have been the immediate cause of death. It is discussed whether intestinal angina could be the cause of the abdominal pain in acute intermittent porphyria.