{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:23:37Z","timestamp":1777994617095,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Acute hepatic porphyria (HP) often presents with recurrent neurovisceral symptoms in young adults, mimicking more common neurological conditions such as Guillain-Barr\u00e9 Syndrome (GBS) and posing significant diagnostic challenges. We report a case of a 25-year-old male who presented with progressive weakness of all 4 limbs over 4\u00a0days, culminating in respiratory paralysis requiring mechanical ventilation. Neurological examination revealed acute flaccid paralysis with areflexia, and nerve conduction studies showed acute motor axonal neuropathy, initially supporting a diagnosis of GBS. However, the patient\u2019s young post-pubertal age, onset in the upper limb with proximal weakness, pure motor axonal neuropathy, and presence of hyponatremia due to the syndrome of inappropriate antidiuresis raised suspicion of acute HP. Screening with qualitative urine porphobilinogen testing, followed by quantitative confirmation, diagnosed acute HP. The patient was treated with intravenous dextrose in the absence of hemin, resulting in gradual clinical improvement. This case underscores the importance of distinguishing acute HP from GBS and the need for early recognition and screening to initiate life-saving therapy.<\/jats:p>","DOI":"10.1177\/19418744251331651","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T16:40:56Z","timestamp":1743525656000},"page":"398-401","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Acute Hepatic Porphyria Presenting as Guillain-Barr\u00e9 Syndrome: Importance of Early Recognition and Screening"],"prefix":"10.1177","volume":"15","author":[{"given":"Kumar Porakapalli","family":"Yuvasai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanveer","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pratiksha Jayant","family":"Pai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sathvik Reddy","family":"Erla","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4476-3478","authenticated-orcid":false,"given":"Ashok Kumar","family":"Pannu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1608634"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20137"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-022-01205-7"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.715523"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2389"},{"issue":"11","key":"e_1_3_4_7_2","first-page":"e48753","article-title":"Acute intermittent porphyria labeled initially as Guillain-Barre syndrome","volume":"15","author":"Alayafi HA","year":"2023","unstructured":"Alayafi HA, Aljumah TK, Alluhayyan OB, Alqaraishi A, Aljwair SA. 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