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Intro: Porphyrias in Primary Care

Neda Frayha, MD and Paul Simmons, MD
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One of our listeners asked, “what’s the deal with porphyria? I don’t get it.” We bet this listener is not alone. Paul and Neda kick off the October episode with a breakdown of acute intermittent porphyria and porphyria cutanea tarda and how we may spot them in primary care. And yes, there is a King George reference.

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Ian L., Dr -

Ought there be preconception screening of HHV -6 by antibody screening in female health workers to alert to the risks and be given the choice whether to work if they wish to become pregnant ?

Neda F., MD -

Hi Ian. That's an interesting question. It raises lots of thought-provoking points. I haven't found any articles on this. And I imagine employers would have reasons not to offer this kind of screening. If you find any literature on the subject, let us know! -- Neda

Ian L., Dr -

HHV 6 can be scary.
Divided into HHV-6A and HHV-6B
HHV-6A is neurotrophic and can cause badness and may cause the fetal damage in pregnancy before 15 weeks .HHV -6B is less nasty and causes sixth disease the disease in infants of really high temperatures 40 C then a few days later the classic rash of infant rosella .Parvovirus 19 that in infants causes the red "slapped face " rash and pruritic lacy rash on the extensor surfaces infants recover but in pregnancy can cause fatal demise if a pregnancy contracts an infection before 20 weeks .
The incidence in pregnancy is 1.5% increasing to 13% in epidemics .Reference : Lassen J et al Am J Epidemiol2012 803-807.
Therefore prenatal testing for immunity to Parvovirus 19 ought be useful as an extension of TORCHS for Councelling as regards precautions .

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Primary Care RAP October 2019 Written Summary 992 KB - PDF

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