Abstract
Congenital erythropoietic porphyria (CEP) is a rare autosomal recessive disorder of porphyrin metabolism in which the genetic defect is the deficiency of uroporphyrinogen III cosynthase (UIIIC). Deficiency of this enzyme results in an accumulation of high amounts of uroporphyrin I in all tissues leading to hemolytic anemia, splenomegaly, erythrodontia, bone fragility, exquisite photosensitivity and mutilating skin lesions. We describe the case of a 23-month-old boy who was cured of his CEP by a matched-sibling allogeneic bone marrow transplant, and review the published clinical experience regarding transplantation in this disease. He is alive and disease-free 15 months post transplant. All of his disease manifestations except for the erythrodontia have resolved. His UIIIC level and stool and erythrocyte porphyrin metabolites have almost completely corrected. He is the sixth child reported to be cured of this disease by stem cell transplantation, five cases being long-term survivors. If patients with this disease have an HLA-matched sibling, then stem cell transplantation should be strongly considered because this is currently the only known curative therapy. Bone Marrow Transplantation (2001) 27, 101–105.
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References
Fritsch C, Bolsen K, Ruzicka T, Goerz G . Congenital erythropoietic porphyria J Amer Ac Derm 1997 36: 594–610
Pierini AM . Rare metabolic disorders: porphyrias. In: Schachner LA, Hansen RC (eds) Pediatric Dermatology McGraw-Hill: New York 1988 1086–1095
Schmid R, Schwartz S, Watson CJ . Porphyrin content of bone marrow and liver in the various forms of porphyria AMA Arch Intern Med 1954 93: 167–190
Menagh F, Reyner CE . Hydroa aestivale: congenital porphyria Arch Dermatol 1951 63: 518–519
Stich W . Die kongenitale Porphyrie, eine erythropatische haemolytische Anamie (Porphyrocytose) Schweiz Med Wochenschr 1958 41: 1012–1014
Weremowicz I . Congenital porphyria with erythrodontia, splenomegaly, and anemia in two sisters Pol Tyg Lek 1954 9: 550–2; 585–589
Gross S . Hematologic studies on erythropoietic porphyria: a new case with severe hemolysis, chronic thrombocytopenia and folic acid deficiency Blood 1964 23: 762–775
Rank JM, Straka JG, Weimer MK et al. Hematin therapy in late onset congenital erythropoietic porphyria Br J Haematol 1990 75: 617–622
Gray CH, Neuberger A . Effect of splenectomy in a case of congenital erythropoietic porphyria Lancet 1952 1: 851–854
Kaufman BM, Bickers HR, Rayne J et al. Congenital erythropoietic porphyria: report of a case Br J Dermatol 1967 79: 210–220
Rosenthal IM, Lipton EL, Asrow G . Effect of splenectomy on porphyria erythropoietica Pediatrics 1969 15: 663–675
Simard H, Barry A, Villaneuve B et al. Porphyrie erythropoietique congenitale Can Med Assoc J 1972 107: 1002–1004
Piomelli S, Poh-Fitzpatrick MB, Seaman C et al. Complete suppression of the symptoms of congenital erythropoietic porphyria by long-term treatment with high-level transfusions New Engl J Med 1986 314: 1029–1031
Pierach CA . Hematin therapy for the porphyric attack Semin Liver Dis 1982 2: 125–131
Watson CJ, Bossenmaier I, Cardinal RA et al. Repression by hematin of porphyrin biosynthesis in erythrocyte precursors in congenital erythropoietic porphyria Proc Natl Acad Sci USA 1974 71: 278–282
Watson CJ . Haematin and porphyria (editorial) New Engl J Med 1975 293: 605–607
Kramer S, Viljoen E, Meyer AM et al. The anemia of erythropoietic porphyria with the first description of the disease in an elderly patient Br J Haematol 1965 11: 666–675
Pain RW, Welch FW, Woodrofe AJ et al. Erythropoietic uroporphyria of Gunther first presenting at 58 years with positive family studies Br Med J 1975 3: 621–623
Chatterji AK, Ghosh SK, Chatterjea LB . Observation of therapeutic aspects of porphyria erythropoietica with special reference to steroid therapy J Assoc Phys India 1963 11: 937–941
Pimstone NR, Gandhi SN, Mukerji SK . Therapeutic efficacy of oral charcoal in congenital erythropoietic porphyria New Engl J Med 1987 316: 390–393
Lischner HW . Cholestyramine and porphyrin-binding Lancet 1966 2: 1079–1080
Tanigawa K, Namba H, Ohtsuru A et al. Plasmasorbent therapy with activated charcoal column for congenital erythropoietic porphyria Dermatology 1994 188: 329–330
Moore MR, McColl KEL, Fitzsimons EJ et al. The porphyrias Blood Rev 1990 4: 88–96
Guarini L, Piomelli S . Hydroxyurea in congenital erythropoietic porphyria New Engl J Med 1994 330: 1091–1092
Kauffman L, Evans DI, Stevens RF, Weinkove C . Bone marrow transplantation for congenital erythropoietic porphyria Lancet 1991 337: 1510–1511
Zix-Kieffer I, Langer B, Eyer D et al. Successful cord blood stem cell transplantation for congenital erythropoietic porphyria (Gunther's disease) Bone Marrow Transplant 1996 18: 217–220
Thomas C, Ged C, Nordmann Y et al. Correction of congenital erythropoietic porphyria by bone marrow transplantation J Pediatr 1996 129: 453–455
Lagarde C, Hamel-Teillac D, DeProst Y et al. Allogeneic bone marrow transplantation in congenital erythropoietic porphyria Ann Dermatol Venereol 1998 125: 114–117
Tezcan I, Xu W, Gurgey A et al. Congenital erythropoietic porphyria successfully treated by allogeneic bone marrow transplantation Blood 1992 92: 4053–4058
Schultz JH . Ein Fall von Pemphigus leprosus, compliciert durch Lepra visceralis Greifswald 1874 863
Gunther H . Die haematoporphyriae Deutsche Arch Klin Med 1911 105: 89–146
Romeo G, Levin EY . Uroporphyrinogen III cosynthase in human congenital erythropoietic porphyria Proc Natl Acad Sci USA 1969 63: 856–863
Mazurier F, Moreau-Gaudry F, Salesse S et al. Gene transfer of the uroporphyrinogen III synthase cDNA into haematopoietic progenitor cells in view of a future gene therapy in congenital erythropoietic porphyria J Inher Metab Dis 1997 20: 247–257
Moreau-Gaudry F, Mazurier F, Benisidhoum M et al. Metabolic correction of congenital erythropoietic porphyria by retrovirus-mediated gene transfer into Epstein–Barr virus-transformed B-cell lines Blood 1995 85: 1449–1453
Moreau-Gaudry F, Ged C, Barbot C et al. Correction of the enzyme defect in cultured congenital erythropoietic porphyria disease cells by retrovirus-mediated gene transfer Hum Gene Ther 1995 6: 13–20
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Shaw, P., Mancini, A., McConnell, J. et al. Treatment of congenital erythropoietic porphyria in children by allogeneic stem cell transplantation: a case report and review of the literature. Bone Marrow Transplant 27, 101–105 (2001). https://doi.org/10.1038/sj.bmt.1702738
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DOI: https://doi.org/10.1038/sj.bmt.1702738
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