Porphyria cutanea tarda in the setting of renal failure. Response to renal transplantation.

BACKGROUND: Porphyria cutanea tarda (PCT) and similar vesiculobullous disorders have been described with increased frequency in patients with chronic renal failure undergoing long-term hemodialysis. Descriptions of over 20 cases of hemodialysis-related PCT have appeared in the literature. The precise cause of PCT in chronic renal failure is unknown, and the treatment of PCT occurring in this setting is complex and often ineffective.

OBSERVATIONS: We describe a patient who developed hemodialysis-related PCT, which, in this patient, was refractory to various treatment modalities. This patient eventually went on to receive a renal transplant and all symptoms of PCT resolved with normalization of urinary porphyrin levels.

CONCLUSIONS: We propose that in PCT refractory to the currently available treatment modalities occurring after the development of chronic renal failure, renal transplantation is indicated as a potentially efficacious therapy.