Acute Intermittent Porphyria (AIP): In-depth Overview including Pathophysiology, Signs and Symptoms, Triggers of Attacks, Diagnosis and Treatment. Acute Intermittent Porphyria is a neuro-visceral porphyria condition that leads to abdominal pain and a variety of neuropsychiatric symptoms. Like other porphyria conditions, it is due to a mutation in an enzyme in the heme synthesis pathway, (specifically, porphobilinogen deaminase enzyme) leading to an accumulation of ALA and PBG. There are many triggers of acute porphyria attacks including medications, hormones, alcohol and smoking, and starvation and fasting. Signs and symptoms of acute intermittent porphyria include abdominal pain, nausea and vomiting, constipation or diarrhea, fatigue, paresthesias, and even seizures. Diagnosis of acute intermittent porphyria involves assessing the levels of porphyrin precursors during an acute attack. Treatment involves inhibiting the heme synthesis pathway.
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