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<p>A&#xa0;19-year-old female patient presented to our clinic with abdominal pain, psychomotor agitation and disorientation. The laboratory analysis revealed severe hyponatremia. Cerebral magnetic resonance imaging (MRI) showed characteristic neuroradiological features of a&#xa0;posterior reversible encephalopathy syndrome (PRES). The detection of a&#xa0;significant increase in the serum concentration of porphyrins confirmed the clinical suspicion of acute intermittent porphyria (AIP). The likely trigger for the sudden AIP exacerbation was the use of levonorgestrel for postcoital contraception. Under treatment with high-dose glucose solution and haem arginate, the abdominal symptoms regressed rapidly.&#xa0;In contrast, neuropsychiatric symptoms improved only gradually, making neurological rehabilitation necessary.</p>

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Abdominalschmerzen und schwere Bewusstseinsstörung bei einer 19-jährigen Patientin

  • 期刊论文

  • 发表日期：

    2025年7月16日

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  • Anton Kozlov,
  • Cleo Mybes,
  • Niklas Falk,
  • Maximilian Franz Schulze-Hagen,
  • Stephan Schlecker,
  • Marc Ulrich Becher

摘要

A 19-year-old female patient presented to our clinic with abdominal pain, psychomotor agitation and disorientation. The laboratory analysis revealed severe hyponatremia. Cerebral magnetic resonance imaging (MRI) showed characteristic neuroradiological features of a posterior reversible encephalopathy syndrome (PRES). The detection of a significant increase in the serum concentration of porphyrins confirmed the clinical suspicion of acute intermittent porphyria (AIP). The likely trigger for the sudden AIP exacerbation was the use of levonorgestrel for postcoital contraception. Under treatment with high-dose glucose solution and haem arginate, the abdominal symptoms regressed rapidly. In contrast, neuropsychiatric symptoms improved only gradually, making neurological rehabilitation necessary.