Case presentation A 23-year-old male was admitted to the hospital with status epilepticus after experiencing multiple episodes of generalized tonic-clonic seizures without regaining consciousness. Because of arm and leg weakness, he was confined to a wheelchair for some time. History Recurrent episodes of hypertension and tachycardia Psychiatric problems – depression and anorexia nervosa Episodic abdominal pain for ten years Laboratory investigations Thyroid-stimulating hormone 3.3 (normal 0.4 and 4.0 mU/L) Autoimmune profile: C-reactive protein 4 mg/L (< 5 mg/L) Urinary Metanephrines 88 (24 to 96 mcg/24 hours) HIV antibodies, negative.
A Hoesch bedside test was positive for urinary porphobilinogen with a concentration of 1490 μmol/L (normal <8·8). Radiological findings A CT scan of the patient's brain revealed no abnormalities. MRI scan revealed bilateral asymmetric vasogenic edema…
