Feigning Acute Intermittent Porphyria

Table 1

Date	Ordering specialist/chief complaint	PBG-Qual	Porphyrins; 24 h urine; quant	Uroporphyrin octa 24 h urine; (3–25 μg/24 h)	Heptacarboxyl porphyrin; 24 h urine; (0–7 μg/24 h)	Hexacarboxyl porphyrin; 24 h urine; (0–6 μg/24 h)	Pentacarboxyl porphyrin; 24 h urine; (0–7 μg/24 h)	Coproporphyrin; 24 h urine; (25–150 μg/24 h)	Porphobilinogen 24 h urine; (0–0.5 mg/24 h)
3/31/200	Heme/onc				Result below reportable range for this analyte	Result below reportable range for this analyte
5/4/200	Heme/onc					Result below reportable range for this analyte	Result below reportable range for this analyte
7/15/2004	Heme/onc	Negative
7/16/2004	Heme/onc	Negative
9/6/2005	Heme/onc; AIP attack	Negative
5/5/2006	Heme/onc	Negative
5/7/2006	Heme/onc	Negative		4	<1	<1	<1	26	0.1
6/3/2006	Heme/onc; abdominal pain, nausea, vomiting	Negative
11/14/2006	EM; unknown+	Negative
12/30/2006	Heme/onc; unknown+	Negative		24	3	<1	3	128	0.3
3/27/2009^#	Heme/onc		Normal	10	3	<1	2	75	0.1

PBG-Qual: qualitative urine porphobilinogen; heme/onc: hematology/oncology specialist; EM: emergency medicine specialist; at university hospital laboratory; unknown+: unknown chief complaint but ordered in the emergency department; ^#test performed at Mayo Medical Laboratories;performed by Nichols Institute, Quest Diagnostics, San Juan Capistrano, CA.