Simultaneous Excretion of Goproporphyrin I and III in a Case of Chronic Porphyria

In the urine and stool of normal individuals there is a small amount of coproporphyrin I present. In many pathological conditions, however, the amount excreted is considerably increased. 1 , 4 and in some conditions, notably lead poisoning, coproporphyrin III is excreted rather than the normal coproporphyrin I. Although it is probable that both types of porphyrins are produced in various diseases, the predominance of one type has made the isolation of both types difficult. In the case described below both coproporphyrin I and coproporphyrin III could be isolated from the feces of a woman suffering from chronic porphyria. Thus, the simultaneous formation of these 2 isomers is established.

The patient in whom this condition occurred was found in the psychiatric ward of the Strong Memorial Hospital. Since exogenous causes, such as lead and drugs, could be excluded, the condition is one of chronic porphyria. The patient was not anemic, did not suffer from abdominal colic and was not photosensitive; there was no evidence of abdominal bleeding. The patient was placed on a meat-free diet and the stool and urine collected. Because of the mental condition of the patient, collections were difficult to make.

The stool contained relatively large amounts of coproporphyrin, small amounts of a coproporphyrin ester and deuteroporphyrin and somewhat larger amounts of protoporphyrin. Only in the case of the coproporphyrin fraction was sufficient material present for identification. The porphyrin was methylated to the methyl ester and the product recrystallized from chloroform-methyl alcohol. After 3 recrystallizations crystals nearly uniform in appearance separated rapidly from the solvent. These melted indefinitely at 192°C. Further recrystallization raised the melting point to 194°C. and finally to 210–212°C.