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Clin Gastroenterol Hepatol. 2010 Mar;8(3):297-302, 302.e1. doi: 10.1016/j.cgh.2009.11.017. Epub 2009 Nov 27.

Associations among behavior-related susceptibility factors in porphyria cutanea tarda.

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1
Division of Human Nutrition, Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA.

Abstract

BACKGROUND & AIMS:

Porphyria cutanea tarda (PCT) is the most common of the human porphyrias and results from an acquired deficiency of hepatic uroporphyrinogen decarboxylase (UROD). Some susceptibility factors have been identified; we examined associations among multiple factors in a large cohort of patients.

METHODS:

Multiple known or suspected susceptibility factors and demographic and clinical features of 143 patients (mean age 52 years, 66% male, 88% Caucasian) with documented PCT (mean onset at 41 +/- 8.8 years) were tabulated; associations were examined by contingency tables, classification and regression tree (CART) analysis, and logistic regression.

RESULTS:

The most common susceptibility factors for PCT were ethanol use (87%), smoking (81%), chronic hepatitis C virus (HCV) infection (69%), and HFE mutations (53%; 6% C282Y/C282Y and 8% C282Y/H63D). Of those who underwent hepatic biopsy or ultrasound, 56% had evidence of hepatic steatosis. Of those with PCT, 66% of females took estrogen, 8% were diabetic, 13% had human immunodeficiency virus (HIV) infection, and 17% had inherited uroporphyrinogen decarboxylase (UROD) deficiency (determined by low erythrocyte UROD activity). Three or more susceptibility factors were identified in 70% of patients. HCV infection in patients with PCT was significantly associated with other behavior-related factors such as ethanol use (odds ratio [OR], 6.3) and smoking (OR, 11.9).

CONCLUSIONS:

Susceptibility factors for PCT were similar to previous studies; most patients had 3 or more susceptibility factors. Associations between PCT and HCV, ethanol or smoking could be accounted for by a history of multiple substance abuse; other factors are distributed more randomly among patients.

PMID:
19948245
PMCID:
PMC2834813
DOI:
10.1016/j.cgh.2009.11.017
[Indexed for MEDLINE]
Free PMC Article
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