Congenital Porphyria

Todayโ€™s path rounds are on ๐œ๐จ๐ง๐ ๐ž๐ง๐ข๐ญ๐š๐ฅ ๐ฉ๐จ๐ซ๐ฉ๐ก๐ฒ๐ซ๐ข๐š! This post is inspired by a recent post by @clinpathkate on Instagram. It has some great images so go check it out!

๐–๐ก๐š๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐‚๐จ๐ง๐ ๐ž๐ง๐ข๐ญ๐š๐ฅ ๐ฉ๐จ๐ซ๐ฉ๐ก๐ฒ๐ซ๐ข๐š is a red to brown discolouration of the bones and teeth, starting from birth, due to the accumulation of ๐ฉ๐จ๐ซ๐ฉ๐ก๐ฒ๐ซ๐ข๐ง๐ฌ (compounds that bind metals, such as heme in red blood cells). The name porphyrin derives from the Greek word prophyra, which means purple, and tells you a bit about what colour these compounds are!

๐–๐ก๐จ ๐ ๐ž๐ญ๐ฌ ๐ข๐ญ?
This condition has primarily been described in several breeds of cattle, but there have also been numerous reports of the condition in cats!

๐–๐ก๐š๐ญ ๐œ๐š๐ฎ๐ฌ๐ž๐ฌ ๐ข๐ญ?
Most cases of porphyria are congenital, and are caused by a genetic deficiency in the enzyme ๐ฎ๐ซ๐จ๐ฉ๐จ๐ซ๐ฉ๐ก๐ฒ๐ซ๐ข๐ง ๐ˆ๐ˆ๐ˆ ๐œ๐จ๐ฌ๐ฒ๐ง๐ญ๐ก๐ž๐ญ๐š๐ฌ๐ž. This enzyme is part of the heme production pathway, which is made up of different steps of porphyrin processing until it eventually becomes heme. Without this enzyme, one of the steps stops completely, and the porphyrins begin to accumulate in the body. They tend to accumulate in the teeth, bones and urine, producing the reddish-brown tinge.

๐–๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐š ๐ฉ๐ซ๐จ๐›๐ฅ๐ž๐ฆ?
In general, this condition isnโ€™t a huge issue for the animal, and they can live a pretty happy life. However, there are a few unique issues with having a lot of porphyrins floating around!

The first issue is ๐ฉ๐ก๐จ๐ญ๐จ๐ฌ๐ž๐ง๐ฌ๐ข๐ญ๐ข๐ณ๐š๐ญ๐ข๐จ๐ง, or skin that is easily damaged by sunlight. This happens because porphyrins in the skin react with the UV light from the sun, and can cause local damage to tissues. So these critters should be kept out of the sun as much as possible!

The second potential issue is ๐ก๐ž๐ฆ๐จ๐ฅ๐ฒ๐ญ๐ข๐œ ๐š๐ง๐ž๐ฆ๐ข๐š, aka destruction of red blood cells. Porphyrin accumulation in red blood cells is directly toxic to them, which can cause their destruction. This can have a whole host of side effects, and generally has a poor prognosis attached to it.

๐‡๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐š๐ ๐ง๐จ๐ฌ๐ž๐?
The best way to diagnose this condition is UV light! When exposed to a black light, the bones will glow pink due to the interactions of the purpley porphyrins and the UV light. Crazy!

๐๐ก๐จ๐ญ๐จ๐ฌ
1) Comparison of the femur of a cat with congenital porphyria (top) to a normal cat femur.
2-3) A femur with congenital porphyria under normal light and UV light!
4-5) More examples of pink bones!

๐’๐จ๐ฎ๐ซ๐œ๐ž๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโ€™s Pathology of Domestic Animals, Volume 1. Sixth Edition.

Photos 1-5 courtesy of Noahโ€™s Arkive.

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