To the Editor.— Horie et al1 recently reported that oral cimetidine in an 800-mg daily dose decreased urinary excretion of 8-aminolevulinic acid (ALA) in a patient with acute intermittent porphyria who was in remission. This study was based on the inhibitory effect of cimetidine on hepatic cytochrome P-450 synthesis and heme oxidase activity, which results in decreased heme consumption with subsequent inhibition of ALA synthetase through a negative feedback mechanism.2 The aim of this letter is to confirm these biologic changes observed by Horie et al and furthermore to see if they are associated with clinical improvement.
Report of a Case.— A 38-year-old white female with a well-documented familial (mother, one sister, and one brother) and personal (two previous attacks) history of acute intermittent porphyria was given 400 mg of cimetidine twice daily from day 0 to day 14. Urinary excretion of ALA and porphobilinogen was measured 7
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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