| Neurologic |
Automatic nervous system symptoms: |
The effects of increased 5-HT activity are similar to some symptoms of |
| symptoms |
abdominal pain, vomiting, constipation, intestinal |
autonomic neuropathy |
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obstruction, arrhythmias, hypertension, etc. |
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Central nervous system damage: |
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Epileptic seizures: |
1. Hyponatremia |
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myoclonic jerks, tonic-clonic seizures, partial |
2. ALA is toxic to neuronal and glial cells |
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seizures followed by secondarily generalized |
3. Increased production of catecholamine can cause vasoconstriction |
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seizures, generalized seizures, etc. |
4. CNS suppression induced by GABA is diminished |
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5. PRES itself can trigger seizures |
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SIADH: |
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loss of appetite, nausea, vomiting, convulsions, |
Excess PBG and ALA cause damage to hypothalamic-hypophyseal tracts |
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coma, etc. |
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PRES: |
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headaches, nausea, seizures, visual disturbances, |
Endothelial dysfunction caused by HHP, toxic damage, and a primary |
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etc. |
inflammatory injury is a major pathogenic process |
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Peripheral neuropathy: |
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pain, muscle weakness, paresis, sensory |
A reduction in heme production disrupts fast axonal transport |
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neuropathy, etc. |
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| Psychiatric |
Depression, anxiety, insomnia, schizophrenia, |
1. Genetic factors |
| symptoms |
hallucinations, etc. |
2. AIP attacks |
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3. Homozygous HMBS mutations (animal study) |
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| Hepatocellular |
Elevated transaminases and hepatalgia |
1. Liver cirrhosis |
| carcinoma |
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2. Elderly patients may have an increased risk |
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3. AIP attacks |
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4. HMBS enzyme deficiency may diminish the inhibition of tumor |
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growth |
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5. The carcinogenicity of ALA |
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6. Decreased heme production reduces hemin's antigenotoxic and |
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anti-inflammatory effects |
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| Renal impairment |
Elevated creatinine and urea nitrogen |
1. Porphyrin precursors can cause tubular injury and severe arteriolar |
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lesions, and PEPT2, a transporter of ALA, plays an important role. |
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2. Hypertension may aggravate renal arteriolosclerosis |
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3. Repeated hemin therapy |
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| Metabolically |
Elevated serum uric acid and |
The exact mechanism is unclear |
| related changes |
hypercholesterolemia |
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