Treatment of hemodialysis-related porphyria cutanea tarda with small repeated phlebotomies.

Phlebotomy is generally thought to be contraindicated in porphyria cutanea tarda (PTC) associated with hemodialysis for the anemia which is often present in uremic patients. We report a patient with a severe form of hemodialysis-related PTC and biochemical parameters suggestive of iron overload in whom treatment with small repeated phlebotomies was well tolerated without any significant worsening of the anemia and gave marked biochemical improvement and complete clinical remission.

Prenylamine-induced ventricular arrhythmias and syncopal attacks with Q-T prolongation. Report of a case and comment on therapeutic use of lignocaine.

A 70-year-old man, on prenylamine for exertional angina, complained of syncopal attacks which seemed to be caused by bursts of ventricular tachycardia associated with Q-T prolongation. These symptoms disappeared after treatment with lignocaine, and the Q-T interval gradually returned to normal when prenylamine was stopped. This communication emphasizes the possibility of the occurrence of Q-T prolongation with associated ventricular arrhythmias in patients treated with prenylamine and the usefulness of a cautious trial with lignocaine in ventricular arrhythmias linked to Q-T prolongation.