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Unlike other forms of porphyria, which are inborn errors of metabolism, <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> is usually an acquired liver disease caused by exogenous factors, chief among which are excess alcohol intake, iron overload, chronic hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>, oestrogen therapy and cigarette smoking. The pathogenesis of <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> is complex and varied, but hereditary or acquired factors that lead to hepatic iron loading and increased oxidative stress are of central importance. Iron loading is usually only mild or moderate in degree [less than that associated with full\u2010blown haemochromatosis (<jats:italic>HFE<\/jats:italic>)] and is usually acquired and\/or mutations in <jats:italic>HFE<\/jats:italic>. Among acquired factors are excessive alcohol intake and chronic hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> infection, which, like mutations in <jats:italic>HFE<\/jats:italic>, decrease hepcidin production by hepatocytes. The decrease in hepcidin leads to increased iron absorption from the gut. In the liver, iron loading and increased oxidative stress leads to the formation of non\u2010porphyrin inhibitor(s) of uroporphyrinogen decarboxylase and to oxidation of porphyrinogens to porphyrins. The treatment of choice of active <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> is iron reduction by phlebotomy and maintenance of a mildly iron\u2010reduced state without anaemia. Low\u2010dose antimalarials (cinchona alkaloids) are also useful as additional therapy or as alternative therapy for active <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> in those without haemochromatosis or chronic hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>. In this review, we provide an update of <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> with special emphasis upon the important role often played by the hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> virus.<\/jats:p>","DOI":"10.1111\/j.1478-3231.2012.02794.x","type":"journal-article","created":{"date-parts":[[2012,4,18]],"date-time":"2012-04-18T03:13:52Z","timestamp":1334718832000},"page":"880-893","source":"Crossref","is-referenced-by-count":99,"title":["Hepatitis <scp>C<\/scp>, porphyria cutanea tarda and liver iron: an update"],"prefix":"10.1111","volume":"32","author":[{"given":"F.","family":"Ryan Caballes","sequence":"first","affiliation":[{"name":"The Liver\u2010Biliary\u2010Pancreatic Center of Carolinas Medical Center Charlotte NC USA"},{"name":"Department of Medicine CMC Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Sendi","sequence":"additional","affiliation":[{"name":"The Liver\u2010Biliary\u2010Pancreatic Center of Carolinas Medical Center Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert L.","family":"Bonkovsky","sequence":"additional","affiliation":[{"name":"The Liver\u2010Biliary\u2010Pancreatic Center of Carolinas Medical Center Charlotte NC USA"},{"name":"Department of Medicine CMC Charlotte NC USA"},{"name":"Department of Medicine Universities of CT and NC Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,4,17]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"397","article-title":"The additive effects of hepatitis C infection and end\u2010stage renal disease in porphyria cutanea tarda","volume":"78","author":"Chan OT","year":"2006","journal-title":"Cutis"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.07.002"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.1997.tb00116.x"},{"key":"e_1_2_12_5_1","first-page":"188","article-title":"Porphyria cutanea tarda, hepatitis C, alcoholism, and hemochromatosis: a case report and review of the literature","volume":"73","author":"Sams H","year":"2004","journal-title":"Cutis"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2004.07.001"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-923317"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.2009.01153.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511666476.045"},{"key":"e_1_2_12_10_1","first-page":"2434","volume-title":"Harrison's: Principles of Internal Medicine","author":"Desnick RJ","year":"2008"},{"key":"e_1_2_12_11_1","first-page":"S86","article-title":"Guide to porphyrias. 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