Use of gonadotropin-releasing hormone analog with tibolone to prevent cyclic attacks of acute intermittent porphyria

A 25-year-old woman with a 10-year history of recurrent attacks of acute ab dominal pain just before menstrual periods had acute intermittent porphyria (AIP) diagnosed when she was 23.5 years old. Many acute attacks required h ospitalization. Suppression of the menstrual cycle with a gonadotropin-rele asing hormone analog (GnRHa; triptorelin) and tibolone administration as ad d-back therapy resulted in absence of acute porphyric attacks. The patient had no acute attacks over a 1-year follow-up period. This case suggests tha t long-term GnRHa therapy with tibolone add-back may be a therapeutic optio n for patients with AIP. Copyright (C) 2001 by W.B. Saunders Company.