Primary hemochromatosis presented by porphyria
cutanea tarda: a case report.
Cases J 2009.:7246.

We present a 27-year-old female Caucasian patient, who initially
presented with extensive fragility and blistering of mainly the
dorsal side of both hands.
Histology and urine porphyrin analysis confirmed the diagnosis
of porphyria cutanea tarda.
Internal screening for underlying disease revealed C282Y
mutation-associated primary hemochromatosis, a hereditary
iron-overload syndrome that may cause toxicity of a variety of
organs.
Hemochromatosis and porphyria cutanea tarda are pathogenetically
linked as iron interferes with heme synthesis pathway.
Patient was successfully treated with phlebotomy and low-dose
hydroxychloroquine.

--------------

http://cme.medscape.com/viewarticle/704384?src=cmemp

Hydroxychloroquine Use May Be Safe in Systemic Lupus Erythematosus

"Because of its broad spectrum of benefits and safety profile,
hydroxychloroquine should be given to most patients with systemic
lupus erythematosus (SLE) during the whole course of the disease,
regardless of severity, and should be continued during pregnancy,
according to the results of a systematic review reported in the June 3
Online First issue of Annals of the Rheumatic Diseases."

---------

"Hydroxychloroquine"

The iron-binding and hydroxyl radical scavenging action of anti-
inflammatory drugs.
Xenobiotica. 1988 Apr;18(4):459-70.
Aruoma OI, Halliwell B.

Department of Biochemistry, University of London King's College,
Strand Campus, UK.

1. Hydroxyl radicals (.OH) are thought to be generated at sites
of inflammation and to contribute to tissue damage.
All anti-inflammatory drugs tested were able to scavenge .OH
generated in free solution at almost diffusion- controlled rates
(rate constants about 10(10)M-1s-1).
2. Much .OH generation in vivo occurs at specific sites, where
bound metal ions (such as Fe2+) react with H2O2 to produce
..OH that immediately attacks the site.
Only .OH scavengers that have sufficient metal-binding ability
to withdraw metal ions from this site can protect against
site-specific damage.
3. All anti-inflammatory drugs tested were able to protect against
site-specific damage by .OH in a simple model system in vitro.
Penicillamine, diclofenac sodium, piroxicam, azathioprine,
primaquine,
chloroquine and hydroxychloroquine were especially effective.
4. The ability of an anti-inflammatory drug to protect against .OH
formation in vivo depends not only on its rate constant for reaction
with .OH, but also on its metal-binding ability and on the geometry
and redox potential of any metal complex formed.

PMID: 3135672

----------------------

Anyone care to venture a guess why phlebotomy / bloodletting hasn't
even been tried in lupus when a drug that is supposed to BE .. an
**alternative** TO **bloodletting** .. IS .. now .. readily
prescribed .. ?

"Hydroxychloroquine should be the preferred alternative to phlebotomy"

Plaquenil - Plaquenil Side Effects - Plaquenil
Hydroxychloroquine has been beneficial for a high
percentage of patients with rheumatoid arthritis and lupus
erythematosus, especially chronic discoid lupus ...

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*------

"Hydroxychloroquine should be the preferred alternative to phlebotomy"

A comparative trial of desferrioxamine and hydroxychloroquine for
treatment of porphyria cutanea tarda in alcoholic patients.
Photodermatol. 1984 Dec;1(6):286-92.
Marchesi L,Di Padova C, Cainelli T, Reseghetti A, Di Padova F,
Rovagnati P, Cantoni L.
Forty male alcoholic patients with porphyria cutanea tarda (PCT)
were randomly assigned to 2 groups of 20.
The 1st group received desferrioxamine (30 mg/kg body weight/day
for 1 week every 3 months) whereas the latter was given
hydroxychloroquine (200 mg twice/wk orally).
Alcohol abstinence was advised for all patients.
Improvement of cutaneous signs was evident after 6 months in
hydroxychloroquine-treated subjects and after 12 months in
desferrioxamine-treated subjects.
At the end of the 1-year clinical trial, significant decreases
of serum iron and ferritin were found in all patients,
irrespective of the therapy.
Urinary total porphyrins were reduced significantly in both
groups, but the drop was significantly more evident in
hydroxychloroquine- than in desferrioxamine-treated subjects.
After 1 year of therapy, 4 desferrioxamine-treated patients
vs 16 hydroxychloroquine-treated subjects acquired a normal urinary
porphyrin pattern.
These results indicate that hydroxychloroquine is more effective
than desferrioxamine in inducing clinical and biochemical remission
of PCT. Accordingly, hydroxychloroquine should be the preferred
alternative to phlebotomy, if the latter is contraindicated.

PMID: 6398430
-------------

Who loves ya.
Tom

Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh

Man Is A Herbivore!
http://tinyurl.com/4rq595