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Acute intermittent porphyria and disturbances in amino-acid metabolism in a psychiatric in-patient population

Published online by Cambridge University Press:  16 April 2020

JCC Rijn-van den Meijdenberg
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
D Fekkes
Affiliation:
Department of Psychiatry and Section Pathophysiology of Behavior, Medical Faculty, Erasmus University Rotterdam, PO Box 1738, 3000PRRotterdam
JHP Wilson
Affiliation:
Department of Internal Medicine, University Hospital Dijkzigt, Dr Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
L Pepplinkhuizen
Affiliation:
Department of Psychiatry and Section Pathophysiology of Behavior, Medical Faculty, Erasmus University Rotterdam, PO Box 1738, 3000PRRotterdam
WMA Verhoeven
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
HML Jansen
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
AB Ederveen
Affiliation:
Vincent van Gogh Institute for Psychiatry, Department of Biological Psychiatry, Stationsweg 46, 5803AC Venray
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Summary

In recent years an enhanced catabolism of serine, with or without the existence of porphyria, has been demonstrated in relation to a specific subtype of psychosis, according to ICD-10 criteria, the acute polymorphic psychosis with or without symptoms of schizophrenia. Since sensory perceptual distortions play a key role in the symptomatology, patients with this disorder are referred to as Acute Polymorphic Psychosis plus psychosensory phenomena (APP+). In a retrospective study, including a total of 140 chronic psychiatric patients, we investigated the prevalence of Acute Intermittent Porphyria (AIP) and APP+. No subjects with AIP were found. In two patients APP+ could be demonstrated, based on both clinical characteristics and positive biochemical markers, ie lowered plasma serine concentration and increased TSM-ratio (100 × Taurine (μmol/l)/Serine concentration * Methionine concentration). In three patients the psychotic disorder was suspected to be present. It is concluded that careful psychiatric diagnosing may reveal specific psychotic disorders with a distinct biological pathogenetic factor, ie a disturbed serine metabolism.

Type
Original article
Copyright
Copyright © Elsevier, Paris 1994

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References

Anderson, PMReddy, RMAnderson, KEDesnick, RJCharacterization of the porphobilinogen deaminase deficiency in acute intermittent porphyria. J Clin Invest 1981;68:112CrossRefGoogle ScholarPubMed
Baruah, SWaziri, KSherman, ANeuroleptic effects on serine and glycine metabolism. Biol Psychiatry 1993;34:544-50CrossRefGoogle ScholarPubMed
Bruinvels, JPepplinkhuizen, LImpaired glycine-serine conversion and increased plasma taurine levels in episodic psychotic patients wilh psychedelic symptoms. J Psychiatr Res 1984;18:307-18CrossRefGoogle Scholar
Bruinvels, JPepplinkhuizen, LDisturbances in serine-glycine metabolism in relation to acute psychosis with psychedelic symptomsIn: Beckman, HRiedere, P eds. Pathochemical Markers in Major Psychoses. Berlin: Springer, 1985:5973CrossRefGoogle Scholar
Bruinvels, JPepplinkhuizen, LFekkes, DSerine metabolism beta-carbolines and psychosesIn: Huether, G ed. Amino Acid Availability and Brain Function in Health and Disease Berlin Heidelberg: Springer-Verlag, 1988:363-8CrossRefGoogle Scholar
Bruinvels, JPepplinkhuizen, LFekkes, DDerangement of one-carbon metabolism in episodic schizo affective psychosis. Pharmacopsychiatry 1988;21:28-32CrossRefGoogle Scholar
DSM III-R. Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, rev. Washington DC: American Psychiatric Association, 1987Google Scholar
Fekkes, DPepplinkhuizen, LBruinvels, J.Changes in serine metabolism by a serum factor present in a group of episodic psychotic patients. Biol Psychiatry 1991;30:966-72CrossRefGoogle Scholar
Fekkes, DPepplinkhuizen, I.Verhcij, RBruinvels, JAbnormal plasma levels of serine, methionine and taurine in transient acute polymorphic psychosis. Psychiatr Res 1993:(in press)CrossRefGoogle Scholar
ICD-10, Classification of Mental and Behavioral Disorders, Geneva: World Health Organization. 1992Google Scholar
Kappas, SSassa, SOalbraith, RANordmann, Y The porphyrias. In: Scriver, CRBeaudet, ALSly, WSValle, D eds. The Metabolic Basis of Inherited Disease, 6th ed. New York: McGraw-Hill, 1980:1305-65Google Scholar
Lishman, W.Organic Psychiatry, Blackwell Scientific Publications, 1987:482-5Google Scholar
Pepplinkhuizen, LBruinvels, JBlom, WMoleman, P.Schizophrenia-like psychosis caused by a metabolic disorder. Lancet 1980;i:454-6CrossRefGoogle ScholarPubMed
Pepplinkhuizen, L.Ritanserin in the treatment of therapy resistent psychosis: 13 pilot case reports. Jan Res Rep 1988:15:109-13Google Scholar
Rao, MLGross, GStrebel, BBraunig, PHuber, GKlosterkotter, J.Serum amino acids, central monoamines, and hormones in drug naive, drug free and neuroleptic-treated schizophrenic patients and healthy subjects. Psychiatry Res 1990:34:243-57CrossRefGoogle ScholarPubMed
Rooj de, FWHamer, CMWilson, JHPurification of porphobilinogendeaminase from human erythrocytes by last protein liquid chromatography. Clin Chim Acta 1987:162:61-8CrossRefGoogle Scholar
Sierscma, PDde Rooij, FWMEdixhoven-Bosdijk, AWilson, JHPErythrocyte porphobilinogen deaminase activity in porphyria cutanea tarda. Clin Chem 1990:36:1779-83CrossRefGoogle Scholar
Spilzer, RL.Endicott, JRobins, E.Research diagnostic criteria, Rationale and reliability. Arch Gan Psychiatry 1978:35:773-82CrossRefGoogle Scholar
Tishler, PVWoodward, BO'Connor, JHolbrook, DASeidman, LJHigh prevalence of intermittent acute porphyria in a psychiatric population. Am J Psychiatry 1985:142:1420-36Google Scholar
Waziri, RMolt, JDrug effects on serine metabolism in psychiatric patients. Psychiatry Res 1986:18:119-26CrossRefGoogle ScholarPubMed
Wilson, JHPde Rooij, FWMte Velde, K.Acute intermittent porphyria in The Netherlands: heterogeneity of the enzyme porphobilinogen deaminase. Neth J Med 1986;29:393-9Google ScholarPubMed
Weiterherg, L.A neuropsychiatric and genetical Investigation of acute intermittent porphyria. Thesis. Svenska Bokförlaget/Norsteds. 1967Google Scholar
Wunderink, LPepplinkhuizen, LBruinvels, J.Nutrition and psychoses. In: van Ree, JMMathysse, S eds, Progress In Brain Research. 1986:65:49-59CrossRefGoogle ScholarPubMed
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