Acute porphyria: Treatment with heme

The characterization of porphyrias as disorders of heme biosynthesis leadin g to hepatic heme deficiency and raised formation and secretion of henze pr ecursors lain the basis for heme treatment. Although mild attacks sometimes respond to glucose administration, severe attacks or symptoms that are lik ely to progress should be treated with heme. The heme compounds used in tre atment are hematin and heme arginate, In our opinion, heme arginate is pref erable to hematin in the treatment of acute porphyrias because of its bette r stability, fewer sine effects, and better documentation of its benefits.