Carbamazepine-induced non-hereditary acute porphyria

Lancet. 1983 Apr 9;1(8328):790-2. doi: 10.1016/s0140-6736(83)91850-0.


Acute intermittent porphyria has hitherto been recognised as an autosomal dominant inborn error of haem metabolism characterised by a depressed activity of the enzyme uroporphyrinogen I synthase (URO.S). A case of non-hereditary acute porphyria, similar to acute intermittent porphyria, following treatment of epilepsy with carbamazepine is reported. Subsequent measurements of erythrocyte URO.S activity in a group of epileptic patients treated with various combinations of anticonvulsant drugs suggest that carbamazepine exerts a direct suppressant effect on URO.S in addition to its indirect enzyme-inducing properties.

Publication types

  • Case Reports

MeSH terms

  • 5-Aminolevulinate Synthetase / blood
  • Acute Disease
  • Adult
  • Carbamazepine / adverse effects*
  • Diagnosis, Differential
  • Epilepsy / blood
  • Epilepsy / drug therapy
  • Erythrocytes / enzymology
  • Female
  • Heme / biosynthesis
  • Humans
  • Hydroxymethylbilane Synthase / blood
  • Leukocytes / enzymology
  • Male
  • Porphyrias / chemically induced*
  • Porphyrias / diagnosis


  • Carbamazepine
  • Heme
  • 5-Aminolevulinate Synthetase
  • Hydroxymethylbilane Synthase