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Acute intermittent porphyria and disturbances in amino-acid metabolism in a psychiatric in-patient population

Published online by Cambridge University Press:  16 April 2020

JCC Rijn-van den Meijdenberg ,
D Fekkes ,
JHP Wilson ,
L Pepplinkhuizen ,
WMA Verhoeven ,
HML Jansen  and
AB Ederveen
JCC Rijn-van den Meijdenberg
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
D Fekkes
Affiliation:
Department of Psychiatry and Section Pathophysiology of Behavior, Medical Faculty, Erasmus University Rotterdam, PO Box 1738, 3000PRRotterdam
JHP Wilson
Affiliation:
Department of Internal Medicine, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
L Pepplinkhuizen
Affiliation:
Department of Psychiatry and Section Pathophysiology of Behavior, Medical Faculty, Erasmus University Rotterdam, PO Box 1738, 3000PRRotterdam
WMA Verhoeven
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
HML Jansen
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
AB Ederveen
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
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Summary

In recent years an enhanced catabolism of serine, with or without the existence of porphyria, has been demonstrated in relation to a specific subtype of psychosis, according to ICD-10 criteria, the acute polymorphic psychosis with or without symptoms of schizophrenia. Since sensory perceptual distortions play a key role in the symptomatology, patients with this disorder are referred to as Acute Polymorphic Psychosis plus psychosensory phenomena (APP+). In a retrospective study, including a total of 140 chronic psychiatric patients, we investigated the prevalence of Acute Intermittent Porphyria (AIP) and APP+. No subjects with AIP were found. In two patients APP+ could be demonstrated, based on both clinical characteristics and positive biochemical markers, ie lowered plasma serine concentration and increased TSM-ratio (100 × Taurine (μmol/l)/Serine concentration * Methionine concentration). In three patients the psychotic disorder was suspected to be present. It is concluded that careful psychiatric diagnosing may reveal specific psychotic disorders with a distinct biological pathogenetic factor, ie a disturbed serine metabolism.

Keywords

acute polymorphic psychosis plus psychosensory phenomenaserine metabolismpsychoses
Type
Original article
Information
European Psychiatry , Volume 9 , Issue 5 , 1994 , pp. 249 - 253
Copyright
Copyright © Elsevier, Paris 1994

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