TY - CHAP M1 - Book, Section TI - The Porphyrias A1 - Bonilla-Guerrero, Ruben A1 - Kloke, Karen M. A1 - Salazar, Denise A1 - Sharma, Rajesh A2 - Sarafoglou, Kyriakie A2 - Hoffmann, Georg F. A2 - Roth, Karl S. PY - 2017 T2 - Pediatric Endocrinology and Inborn Errors of Metabolism, 2e AB - The porphyrias are a group of inborn errors of metabolism resulting from enzymatic defects in heme biosynthesis. The majority of the porphyrias are inherited in an autosomal dominant manner, with most subjects retaining approximately 50% of normal enzyme activity. In most cases, this is sufficient to maintain heme biosynthesis. However, the pathway can be upregulated by precipitating factors that increase the demand for heme. Depending on which enzyme is defective, different heme pathway intermediates are overproduced, accumulate, and are excreted in urine, feces, or both. The excess amount of these intermediates gives rise to clinical manifestations which may include neurological and psychological symptoms and/or cutaneous photosensitivity. Heme pathway enzymes can also be disrupted in other disorders, by heavy metal toxicity, or by various chemicals, with the resulting clinical picture resembling a porphyria. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/18 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1140318774 ER -