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KMID : 0356920140670030217
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Korean Journal of Anesthesiology
2014 Volume.67 No. 3 p.217 ~ p.220
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Severe neurologic manifestations in acute intermittent porphyria developed after spine surgery under general anesthesia: a case report
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Park Eun-Young
Kim Yi-Seul
Lim Kyung-Jee
Lee Hye-Kyoung
Lee Soo-Kyung
Choi Hyun
Kang Mae-Hwa
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Abstract
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Porphyrias are inherited metabolic disorders resulting from a specific enzyme defect in the heme biosynthetic pathway. Porphyrias are induced by various precipitants. Clinical features include abdominal pain, neurologic manifestations, autonomic neuropathy, and mental disturbance. Diagnosis may be delayed because of variable symptoms that mimic other diseases and because of the rarity of of porphyrias. Although most patients with known porphyria can complete anesthesia and surgery safely, undiagnosed porphyric patients are in danger of porphyric crisis due to inadvertent exposure to precipitating drugs and environment. We report a case of a patient who experienced delayed emergence with neurological disturbance after general anesthesia, ultimately diagnosed as acute intermittent porphyria.
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KEYWORD
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Delayed emergence from anesthesia, General anesthesia, Guillain-Barre Syndrome, Porphyrias, Wernicke encephalopathy
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