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On readmission for seizures a day later, she was extensively worked up for altered mental state. Despite normalisation of serum sodium concentration and control of her seizures, she remained unwell. Further investigations later confirmed a diagnosis of acute porphyria. The aim of this case report is to highlight the non-specific nature of presentation of acute porphyria and the importance of considering it as a differential diagnosis in cases of abdominal pain with neuropsychiatric features.<\/jats:p>","DOI":"10.1136\/bcr-2021-241580","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T12:55:23Z","timestamp":1624971323000},"page":"e241580","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Unexpected presentation of acute porphyria"],"prefix":"10.1136","volume":"14","author":[{"given":"Chiun Khang","family":"Kiew","sequence":"first","affiliation":[{"name":"General Medicine Department, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline Serena Ee Ling","family":"Lam","sequence":"additional","affiliation":[{"name":"General Medicine Department, Tan Tock Seng Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"2025082802302763000_14.6.e241580.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61925-5"},{"key":"2025082802302763000_14.6.e241580.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2015.05.009"},{"key":"2025082802302763000_14.6.e241580.3","doi-asserted-by":"publisher","DOI":"10.1177\/0004563212474555"},{"key":"2025082802302763000_14.6.e241580.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-012-9544-4"},{"key":"2025082802302763000_14.6.e241580.5","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1532\/IJH97.03127","article-title":"Porphyrias in Japan: compilation of all cases reported through 2002","volume":"79","author":"Kondo","year":"2004","journal-title":"Int J Hematol"},{"key":"2025082802302763000_14.6.e241580.6","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5582\/irdr.2020.03082","article-title":"Recent advances in the epidemiology and genetics of acute intermittent porphyria","volume":"9","author":"Ma","year":"2020","journal-title":"Intractable Rare Dis Res"},{"key":"2025082802302763000_14.6.e241580.7","first-page":"73","article-title":"Acute intermittent porphyria in an Indian male adult","volume":"25","author":"Ng","year":"1984","journal-title":"Singapore Med J"},{"key":"2025082802302763000_14.6.e241580.8","first-page":"451","article-title":"Acute intermittent porphyria (AIP)--an unusual cause of acute confusional state. 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