{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:35:12Z","timestamp":1791477312871,"version":"4.3.4"},"reference-count":100,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Acute hepatic porphyrias (AHPs) represent inherited metabolic disorders of the heme biosynthesis pathway, leading to neurological and systemic impairment. Despite the presence of well-recognized chronic symptoms and signs, acute neurological, both neuromuscular and central neurological complications pose a significant challenge in clinical practice, with a potential risk of greater severity and mortality during acute decompensation episodes of AHPs. Care related to the prescription of medications, considering the risk of porphyrinogenicity, is a major and recurring concern in the acute and chronic management of AHP patients. Infectious clinical complications are significant issues in both outpatient and hospital settings for patients with AHPs. It is crucial to identify therapeutic regimens with the best safety and efficacy profiles for treating such infectious complications in AHP patients. The scarcity of structured knowledge available in guidelines and recommendations often leads to the use of therapeutic options with higher potential risks in treating patients with AHPs. Objectives: This review article aims to provide practical recommendations for managing the most significant infectious complications in clinical practice, with a focus on their impact on the clinical care of patients with AHPs.<\/jats:p>","DOI":"10.3390\/metabo15020099","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T07:44:59Z","timestamp":1738741499000},"page":"99","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Practical Recommendations in the Treatment of Acute and Chronic Life-Threatening Infectious Diseases in Patients with Acute Hepatic Porphyria"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-0494","authenticated-orcid":false,"given":"Bruno de Mattos Lombardi","family":"Badia","sequence":"first","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo de Lima","family":"Serrano","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Paulo","family":"Barile","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Delgado","family":"Seneor","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia Marques","family":"Mendes","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renan Brand\u00e3o Rambaldi","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaliny Oliveira","family":"Peixoto","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor Braga","family":"Farias","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Ismael Lacerda","family":"Machado","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0150-525X","authenticated-orcid":false,"given":"Wladimir Bocca Vieira de Rezende","family":"Pinto","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-4937","authenticated-orcid":false,"given":"Acary Souza Bulle","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7416-7108","authenticated-orcid":false,"given":"Paulo","family":"Sgobbi","sequence":"additional","affiliation":[{"name":"Division of Neuromuscular Diseases, Porphyria Unit, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo 04039-060, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1055\/s-0043-1776760","article-title":"The Hepatic Porphyrias: Revealing the complexities of a rare disease","volume":"43","author":"Balogun","year":"2023","journal-title":"Semin. 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