Clinical problem-solving: Still hazy after all these years

Marwan S. Akasheh, A. C. Deacon, Benjamin Djulbegovic, Stephen G. Reich, Eldad Ben-Chetrit, Chaim Putterman

Research output: Contribution to journalLetterpeer-review

2 Scopus citations


To the Editor: In the medical conundrum presented by Ben-Chetrit and Putterman (Oct. 6 issue),1 despite a 21-year search for a diagnosis, the patient's illness remains hazy. The diagnosis is most obviously hereditary coproporphyria. The patient and her brother were both affected. The patient had a 21-year history of recurrent abdominal pain, with neither clinical nor surgical peritonitis and in the absence of remarkable sequelae. There was evidence of autonomic disturbances: a rapid pulse, an episode of urinary retention, and decreased peristalsis with dilated loops on a plain film of the abdomen. There was also evidence of neuropsychiatric phenomena: anxiety,.  . .

Original languageEnglish
Pages (from-to)332-333
Number of pages2
JournalNew England Journal of Medicine
Issue number5
StatePublished - 2 Feb 1995
Externally publishedYes


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