Evidence map›Paper›PMID 41127737›Full record

ArticleCureus2025

Neurovisceral Syndrome in a Patient with Monoclonal Gammopathy of Undetermined Significance: A Confirmed Case of Variegate Porphyria.

Iraj Fatima, Kashaf Ad Duja Awais, Aasim Sehbai, Ali Awais Khan Tareen, Maheen Shaharyar

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Iraj FatimaDepartment of Medicine, Dubai Medical University, Dubai, ARE.
Kashaf Ad Duja AwaisDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
Aasim SehbaiDepartment of Hematology and Oncology, Alabama Cancer Care (ALCC), Anniston, USA.
Ali Awais Khan TareenDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
Maheen ShaharyarDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Variegate porphyria (VP) is a rare disorder presenting with cutaneous, neurological, and systemic symptoms. We report a 53-year-old man initially hospitalized for a depressive episode, during which blistering lesions and facial flushing were noted. He was misdiagnosed and treated for cellulitis and contact dermatitis without improvement. Repeated misdiagnoses led to extensive autoimmune, infectious, and hematologic workup, revealing coexisting monoclonal gammopathy of undetermined significance (MGUS). Over the following months, he developed abdominal pain, mood swings, cognitive impairment, neuropathy, orthostatic symptoms, and weight loss, raising suspicion for porphyria. A 24-hour urine panel revealed elevated porphobilinogen (PBG), delta-aminolevulinic acid (ALA), coproporphyrin I and III, heptacarboxyl porphyrins, and mildly elevated uroporphyrins, confirming VP. Treatment with hemin caused thrombophlebitis and was discontinued. He was transitioned to Givosiran, resulting in symptom control and no further flares. This case reinforces the need to consider rare metabolic disorders in unexplained multisystem presentations and highlights the role of enzyme-targeting therapy when conventional treatment is not tolerated.

Indexed as

acute hepatic porphyriaautonomic nervous system dysfunctionmonoclonal gammopathy of undetermined significance (mgus)neuropsychiatric symptomneurovisceral attacksperipheral neuropathyvariegate porphyria

Identifiers

PMID41127737
PMCPMC12538662

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.