Environmental chemical exposures and disturbances of heme synthesis

Environmental Health Perspectives

Volumn 105, Issue SUPPL. 1, 1997, Pages 37-53

  Daniell, William E ^a   Stockbridge, Henry L ^b   Labbe, Robert F ^a   Woods, James S ^a   Anderson, Karl E ^c   Bissell, D Montgomery ^d   Bloomer, Joseph R ^e   Ellefson, Ralph D ^f   Moore, Michael R ^g   Pierach, Claus A ^h   Schreiber, William E ⁱ   Tefferi, Ayalew ^f   Franklin, Gary M ^b  

^a UNIVERSITY OF WASHINGTON   (United States)

^b WASHINGTON STATE DEPARTMENT OF LABOR AND INDUSTRIES   (United States)

^c UNIVERSITY OF TEXAS MEDICAL BRANCH   (United States)

^d UNIVERSITY OF CALIFORNIA   (United States)

^e Center for Palliative Care   (United States)

^f MAYO CLINIC   (United States)

^g UNIVERSITY OF QUEENSLAND   (Australia)

^h UNIVERSITY OF MINNESOTA   (United States)

ⁱ UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

Biological markers; Diagnosis; Environmental exposure; Hexachlorobenzene; Laboratory; Lead; Metals; Multiple chemical sensitivity; Occupational exposure; Porphyria; Porphyrins

Indexed keywords

ENVIRONMENTAL CHEMICAL; HALOGENATED HYDROCARBON; HEXACHLOROBENZENE; METAL; PORPHYRIN;

BLOOD; ENVIRONMENTAL EXPOSURE; FECES; FOOD CONTAMINATION; HEME SYNTHESIS; HUMAN; MULTIPLE CHEMICAL SENSITIVITY; OCCUPATIONAL EXPOSURE; PORPHYRIA; PORPHYRIA CUTANEA TARDA; PORPHYRIN METABOLISM; PRACTICE GUIDELINE; PRECURSOR; PRIORITY JOURNAL; REVIEW; URINE; WHEAT;

EID: 0030889450     PISSN: 00916765     EISSN: None     Source Type: Journal    
DOI: 10.1289/ehp.97105s137     Document Type: Review

References (196)

1. Moore MR, McColl KEL, Rimington C, Goldberg A. Disorders of Porphyrin Metabolism. New York:Plenum Medical Book Co, 1987.
2. Bonkovsky HL. Porphyrin and heme metabolism and the porphyrias. In: Hepatology: A Textbook of Liver Disease. 2nd ed (Zakim D, Boyer TD, eds). Philadelphia:WB Saunders, 1990;378-424.
3. Bloomer JR, Straka JG, Rank JM. The porphyrias. In: Diseases of the Liver. 7th ed (Schiff L, Schiff ER, eds). Philadelphia:JB Lippincott Co, 1993;1438-1464.
4. Lee GR. Porphyria. In: Wintrobe's Clinical Hematology, 9th ed (Lee GR, Bithell TC, Foerster J, Athens JW, Lukens JN, eds). Philadelphia:Lea & Febiger, 1993;1272-1297.
5. Moore MR. Biochemistry of porphyria. Int J Biochem 25:1353-1368 (1993).
6. Desnick RJ, Anderson KE. Heme biosynthesis and its disorders: porphyrias and sideroblastic anemias. In: Hematology: Basic Principles and Practice. 2nd ed (Hoffman R, Benz EJ Jr, Shattil SJ, Furie B, Cohen HJ, Silberstein LE, eds). New York:Churchill Livingstone, 1995;523-545.
7. Kappas A, Sassa S, Galbraith RA, Nordmann Y. The porphyrias. In: The Metabolic and Molecular Bases of Inherited Disease. 7th ed (Scriver CR, Beaudet AL, Sly WS, Valle D, eds). New York:McGraw-Hill, 1995;2103-2159.
8. Perlroth MG. The porphyrias. In: Scientific American Medicine (Rubenstein E, Federman DD, eds). New York:Scientific American, 1994;Section 9(V):1-15.
9. Sassa S. The porphyrias. In: Williams Hematology. 5th ed (Beutler E, Lichtman MA, Coller BS, Kipps TJ, eds). New York:McGraw-Hill, 1995;726-746.
10. Anderson KE. The porphyrias. In: Cecil Textbook of Medicine. 20th ed (Bennett JC, Plum F, eds). Philadelphia:WB Saunders, 1996;1124-1131.
11. Rossi E, Taketani S, Garcia-Webb P. Lead and the terminal mitochondrial enzymes of haem biosynthesis. Biomed Chromatogr 7:1-6 (1993).
12. Ostrowski J, Kostrzewska E, Michalak T, Zawirska B, Medrzejewski W, Gregor A. Abnormalities in liver function and morphology and impaired aminopyrine metabolism in hereditary hepatic porphyrias. Gastroenterology 85:1131-1137 (1983).
13. Hardell L, Bengtssom NO, Jonsson U, Eriksson S, Larsson LG. Aetiological aspects on primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria - an epidemiological investigation. Br J Cancer 50:389-397 (1984).
14. Lithner F, Wetterberg L. Hepatocellular carcinoma in patients with acute intermittent porphyria. Acta Med Scand 215:271-274 (1984).
15. Kauppinen R, Mustajoki P. Acute hepatic porphyria and hepatocellular carcinoma. Br J Cancer 57:117-120 (1988).
16. Brodie MJ, Thompson GG, Moore MR, Beattie AD, Goldberg A. Hereditary coproporphyria: demonstration of the abnormalities in haem biosynthesis in peripheral blood. Q J Med 46:229-241 (1977).
17. Andrews J, Erdjument H, Nicholson DC. Hereditary coproporphyria: incidence in a large English family. J Med Genet 21:341-349 (1984).
18. Kauppinen R, Mustajoki P. Prognosis of acute porphyria: occurrence of acute attacks, precipitating factors, and associated diseases. Medicine 71:1-13 (1992).
19. Ridley A. The neuropathy of acute intermittent porphyria. Q J Med 38(151):307-333 (1969).
20. Stein JA, Tschudy DP. Acute intermittent porphyria: a clinical and biochemical study of 46 patients. Medicine 49:1-16 (1970).
21. Leonhardt KF, von Tiepermann R, Doss M. Family studies of patients with acute intermittent porphyria (AIP): neurological, biochemical, and genetic investigations. In: Diagnosis and Therapy of Porphyrias and Lead Intoxication (Doss M, ed). New York:Springer-Verlag, 1978;94-99.
22. Kaelbling R, Craig JB, Pasamanick B. Urinary porphobilinogen: results of screening 2,500 psychiatric patients. Arch Gen Psychiatry 5:494-508 (1961).
23. McEwin R, Lawn J, Jonas CT. A survey of porphyria among psychiatric patients. Med J Aust 2:303-306 (1972).
24. Tishler PV, Woodward B, O'Connor J, Holbrook DA, Seidman LJ, Hallett M, Knighton DJ. High prevalence of intermittent acute porphyria in a psychiatric patient population. Am J Psychiatry 142:1430-1436 (1985).
25. Patience DA, Blackwood DH, McColl KE, Moore MR. Acute intermittent porphyria and mental illness - a family study. Acta Psychiatr Scand 89:262-267 (1994).
26. Mustajoki P, Koskelo P. Hereditary hepatic porphyrias in Finland. Acta Med Scand 200:171-178 (1976).
27. Eales L, Day RS, Blekkenhorst GH. The clinical and biochemical features of variegate porphyria: an analysis of 300 cases studied at Groote Schuur Hospital, Cape Town. Int J Biochem 12:837-853 (1980).
28. Toback AC, Sassa S, Poh-Fitzpatrick MB, Schechter J, Zaider E, Harber LC, Kappas A. Hepatoerythropoietic porphyria: clinical, biochemical, and enzymatic studies in a three-generation family linkage. N Engl J Med 316:645-650 (1987).
29. Fujimoto A, Brazil JL. Hepatoerythropoietic porphyria in a woman with short stature and deformed hands. Am J Hum Genet 44:496-499 (1992).
30. Bickers DR. The dermatologic manifestations of human porphyria. Ann NY Acad Sci 514:261-267 (1987).
31. DeLeo VA, Poh-Fitzpatrick M, Mathews-Roth M, Harber LC. Erythropoietic protoporphyria: 10 years experience. Am J Med 60:8-22 (1976).
32. Elder GH, Uruquhart AJ, de Salamanca RE, Munoz JJ, Bonkovsky HL. Immunoreactive uroporphyrinogen decarboxylase in porphyria cutanea tarda. Lancet 2(8449):229-233 (1985).
33. Sweeney GD. Porphyria cutanea tarda, or the uroporphyrinogen decarboxylase deficiency diseases. Clin Biochem 19(2):3-15 (1986).
34. Fargion S, Piperno A, Cappellini MD, Sampietro M, Fracanzani AL, Romano R, Caldarelli R, Marcelli R, Vecchi L, Fiorelli G. Hepatitis C virus and porphyria cutanea tarda: evidence of a strong association. Hepatology 16:1322-1326 (1992).
35. DeCastro M, Sanchez J, Herrera JF, Chaves A, Duran R, Garcia-Buey L, Garcia-Monzon C, Sequi J, Moreno-Otero R. Hepatitis C virus antibodies and liver disease in patients with porphyria cutanea tarda. Hepatology 17:551-557 (1993).
36. Herrero C, Vicente A, Bruguera M, Ercilla MG, Barrera JM, Vidal J, Teres J, Mascaro JM, Rodes J. Is hepatitis C virus infection a trigger of porphyria cutanea tarda? Lancet 341:788-789 (1993).
37. Navas S, Bosch O, Castillo I, Marriott E, Carreno V. Porphyria cutanea tarda and hepatitis C and B viruses infection: a retrospective study. Hepatology 21:279-284 (1995).
38. Stolzel U, Kostler E, Koszka C, Stoffler-Meilicke M, Schuppan D, Somasundaram R, Doss MO, Habermehl KO, Riecken EO. Low prevalence of hepatitis C virus infection in porphyria cutanea tarda in Germany. Hepatology 21:1500-1503 (1995).
39. Doss MO. Hepatic porphyrias: pathobiochemical, diagnostic, and therapeutic implications. In: Progress in Liver Diseases (Popper H, Schaffner F, eds). New York:Grune & Stratton, 1982;573-597.
40. Kordac V. Frequency of occurrence of hepatocellular carcinoma in patients with porphyria cutanea tarda in long-term followup. Neoplasma 19:135-139 (1972).
41. Cortes JM, Oliva J, Paradinas FJ, Hernandez-Guio C. The pathology of the liver in porphyria cutanea tarda. Histopathology 4:471-485 (1980).
42. Packe GE, Clarke CFW. Is porphyria cutanea tarda a risk factor in the development of hepatocellular carcinoma? A case report and review of the literature. Oncology 42:44-47 (1985).
43. Tio TH, Leijnse B, Jarrett A, Rimington C. Acquired porphyria from a liver tumor. Clin Sci 16:517-524 (1957).
44. Thompson RPH, Nicholson DC, Farnan MB, Whitmore DN, Williams R. Cutaneous porphyria due to a malignant primary hepatoma. Gastroenterology 59:779-783 (1970).
45. Waddington RT. A case of primary liver tumour associated with porphyria. Br J Surg 59:653-654 (1972).
46. Moore MR, Disler PB. Biochemical diagnosis of the porphyrias. Clin Dermatol 3(2):24-40 (1985).
47. Beukeveld GJJ, Wolthers BG, van Saene JJM, de Haan THIJ, de Ruyter-Buitenhuis LW, van Saene RHF. Patterns of porphyrin excretion in feces as determined by liquid chromatography: reference values and the effect of flora suppression. Clin Chem 33:2164-2170 (1987).
48. Logan GM, Weimer MK, Ellefson M, Pierach CA, Bloomer JR. Bile porphyrin analysis in the evaluation of variegate porphyria. N Engl J Med 324:1408-1411 (1991).
49. Meyer UA, Strand LJ, Doss M, Rees AC, Marver HS. Intermittent acute porphyria - demonstration of a genetic defect in porphobilinogen metabolism. N Engl J Med 286:1277-1282 (1972).
50. Shimizu Y, Ida S, Naruto H, Urata G. Excretion of porphyrins in urine and bile after the administtation of delta-aminolevulinic acid. J Lab Clin Med 92:795-802 (1978).
51. Anderson KE, Drummond GS, Freddara U, Sardana MK, Sassa S. Porphyrogenic effects and induction of heme oxygenase in vivo by δ-aminolevulinic acid. Biochim Biophys Acta 676:289-299 (1981).
52. Elder GH, Smith SG, Smyth SJ. Laboratory investigation of the porphyrias. Ann Clin Biochem 27:395-412 (1990).
53. Kushner JP. Editorial: Laboratory diagnosis of the porphyrias. N Engl J Med 324:1432-1434 (1991).
54. Tefferi A, Solberg LA, Jr., Ellefson RD. Porphyrias: clinical evaluation and interpretation of laboratory tests. Mayo Clin Proc 69:289-290 (1994).
55. Waldenstrom J. The porphyrias as inborn errors of metabolism. Am J Med 22:758-773 (1957).
56. Ackner B, Cooper JE, Gray CH, Kelly M, Nicholson DC. Excretion of porphobilinogen and δ-aminolaevulinic acid in acute porphyria. Lancet 1:1256-1260 (1961).
57. Mahood WH, Killough JH. Acute intermittent porphyria: a clinical and laboratory study of a large family. Ann Intern Med 64:259-267 (1966).
58. Dean G, Kramer S, Lamb P. Coproporphyria. S Afr Med J 43:138-142 (1969).
59. Taylor JS. Porphyria cutanea tarda symptomatica. Cutis 6:1261-1274 (1970).
60. Epstein JH, Pinski JB. Porphyria cutanea tarda: association with abnormal iron metabolism. Arch Dermatol 92:362-366 (1965).
61. Dowdle E, Goldswain P, Spong N, Eales L. The pattern of porphyrin isomer accumulation and excretion in symptomatic porphyria. Clin Sci 39:147-158 (1970).
62. Lundvall O, Weinfeld A, Lundin P. Iron storage in porphyria cutanea tarda. Acta Med Scand 188:37-53 (1970).
63. Reizenstein P, Hoglund S, Landegren J, Carlmark B, Forsberg K. Iron metabolism in porphyria cutanea tarda. Acta Med Scand 198:95-99 (1975).
64. Kushner JP, Barbuto AJ, Lee GR. An inherited enzymatic defect in porphyria cutanea tarda: decreased uroporphyrinogen decarboxylase activity. J Clin Invest 58:1089-1097 (1976).
65. Felsher BF, Norris ME, Shih JC. Red-cell uroporphyrinogen decarboxylase activity in porphyria cutanea tarda and in other forms of porphyria. N Engl J Med 299:1095-1098 (1978).
66. Topi G, D'Alessandro Gandolfo L. Inheritance of porphyria cutanea tarda: analysis of 14 cases in 5 families. Br J Dermatol 97:617-627 (1977).
67. Grossman ME, Bickers DR, Poh-Fitzpatrick MB, Deleo VA, Harber LC. Porphyria cutanea tarda: clinical features and laboratory findings in 40 patients. Am J Med 67:277-286 (1979).
68. Kordac V, Jirsa M, Kalab M. Chloroquine in the treatment of porphyria cutanea tarda. In: Diagnosis and Therapy of Porphyrias and Lead Intoxication (Doss M, ed). New York:Springer-Verlag, 1978;127-132.
69. von Tiepermann R, Doss M. Uroporphyrinogen decarboxylase (Uro-D) defect in erythrocytes in chronic hepatic porphyrias. In: Diagnosis and Therapy of Porphyrias and Lead Intoxication (Doss M, ed). New York:Springer-Verlag, 1978;111-116.
70. Elder GH, Sheppard DM, de Salamanca RE, Olmos A. Identification of two types of porphyria cutanea tarda by measurement of erythrocyte uroporphyrinogen decarboxylase. Clin Sci 58:477-484 (1980).
71. Reed WB, Wuepper KD, Epstein JH, Redeker A, Simonson RJ, McKusick VA. Erythropoietic protoporphyria: a clinical and genetic study. JAMA 214:1060-1066 (1970).
72. de Verneuil H, Beaumont C, Deybach J-C, Nordmann Y, Sfar Z, Kastally R. Enzymatic and immunological studies of uroporphyrinogen decarboxylase in familial porphyria cutanea tarda and hepatoerythropoietic porphyria. Am J Hum Genet 36:613-622 (1984).
73. McColl KEL, Goldberg A. Abnormal porphyrin metabolism in diseases other than porphyria. Clin Haematol 9:427-444 (1980).
74. Doss MO. Alcohol and porphyrin metabolism. In: Alcohol Related Diseases in Gastroenterology (Seitz HK, Kommerell B, eds). New York:Springer-Verlag, 1985:232-252.
75. Doss MO. Porphyrinurias and occupational disease. Ann NY Sci 514:204-218 (1987).
76. Sieg I, Doss MO, Kandels H, Schneider J. Effect of alcohol on δ-aminolevulinic acid dehydratase and porphyrin metabolism in man. Clin Chim Acta 202:211-218 (1991).
77. Doss M. Pathobiochemical transition of secondary coproporphyrinuria to chronic hepatic porphyria in humans. Klin Wochenschr 58:141-148 (1980).
78. Bissell DM. Porphyria. In: Cecil Textbook of Medicine. 18th ed (Wyngaarden JB, Smith LH Jr, eds). Philadelphia:WB Saunders, 1988;1182-1187.
79. Bloomer JR, Bonkovsky HL. The porphyrias. Dis Mon 35:1-54 (1989).
80. Rank JM, Straka JG, Bloomer JR. Porphyria. In: Liver and Biliary Diseases (Kaplowitz N, ed). Baltimore:Williams & Wilkins, 1992;479-492.
81. Wyckoff EE, Kushner JP. Heme biosynthesis, the porphyrias, and the liver. In: The Liver: Biology and Pathobiology. 3rd ed (Arias IM, Boyer JL, Fausto N, Jakoby WB, Schachter DA, Shafritz DA, eds). New York:Raven, 1994;505-527.
82. Watson CJ. Porphyrin metabolism in the anemias. Arch Intern Med 99:323-333 (1957).
83. Kaplowitz N, Javitt N, Kappas A. Coproporphyrin I and III excretion in bile and urine. J Clin Invest 51:2895-2899 (1972).
84. Day RS, Eales L, Disler PB. Editorial: Porphyrias and the kidney. Nephron 28:261-267 (1981).
85. Henderson MJ, Toothill C. Urinary coproporphyrin in lead intoxication: a study in the rabbit. Clin Sci 65:527-532 (1983).
86. Woods JS. Regulation of porphyrin and heme metabolism in the kidney. Semin Hematol 25:336-348 (1988).
87. Woods JS, Martin MD, Naleway CA, Echeverria D. Urinary porphyrin profiles as a biomarker of mercury exposure: studies on dentists with occupational exposure to mercury vapor. J Toxicol Environ Health 40:235-246 (1993).
88. Doss M. Chronic hepatic porphyrias in humans (endogenic factors). In: Chemical Porphyria in Man (Strik JJTWA, Koeman JH, eds). Amsterdam:Elsevier/North-Holland, 1979;11-25.
89. Doss M, Schermuly E, Koss G. Hexachlorobenzene porphyria in rats as a model for human chronic hepatic porphyrias. Ann Clin Res 8 (Suppl 17):171-181 (1976).
90. Doss MO, Sassa S. The porphyrias. In: Laboratory Medicine: The Selection and Interpretation of Clinical Laboratory Studies (Noe DA, Rock RC, eds). Baltimore:Williams & Wilkins, 1994;535-553.
91. Day RS, Blekkenhorst GH, Eales L. Drug induced acute porphyric episodes in rats. Int J Biochem 12:1007-1011 (1980).
92. Woods JS, Southern MR. Studies on the etiology of trace metal-induced porphyria: effects of porphyrinogenic metals on coproporphyrinogen oxidase in rat liver and kidney. Toxicol Appl Pharmacol 97:183-190 (1989).
93. Moore MR, McColl KEL. Therapy of the acute porphyrias. Clin Biochem 22:181-188 (1989).
94. Moore MR. Acute porphyrias. British National Formulary 31:401-402 (1996).
95. McColl KEL, Dover SB, Fitzsimons EJ, Moore MR. Porphyrin metabolism and the porphyrias. In: Oxford Textbook of Medicine. 3rd ed (Weatherall DJ, Ledingham JGG, Warrell DA, eds). Oxford:Oxford University Press, 1996;1388-1399.
96. Strik JJTWA, Debets FMH, Koss G. Chemical porphyria. In: Halogenated Biphenyls, Terphenyls, Naphthalenes, Dibenzodioxins and Related Products (Kimbrough RD, ed). Amsterdam:Elsevier/North-Holland Biomedical Press, 1980;191-239.
97. Marks GS. Exposure to toxic agents: the heme biosynthetic pathway and hemoproteins as indicator. CRC Crit Rev Toxicol 15(2):151-179 (1985).
98. Woods JS. Porphyrin metabolism as indicator of metal exposure and toxicity. In: Toxicology of Metals; Biochemical Aspects. Handbook of Experimental Pharmacology, Vol 115 (Goyer RA, Cherian MG, eds). New York:Springer-Verlag, 1995;19-52.
99. Schmid R. Cutaneous porphyria in Turkey. N Engl J Med 263:397-398 (1960).
100. Cam C, Nigogosyan G. Acquired toxic porphyria cutanea tarda due to hexachlorobenzene. Report of 348 cases caused by this fungicide. JAMA 183:88-91 (1963).
101. Dogramaci I. Porphyrias and porphyrin metabolism with special reference to porphyria in childhood. Adv Pediatr 13:11-63 (1964).
102. Peters HA, Johnson SAM, Cam S, Oral S, Muftu Y, Ergene T. Hexachlorobenzene-induced porphyria:effect of chelation on the disease, porphyrin and metal metabolism. Am J Med Sci 251:314-322 (1966).
103. Peters HA, Gocmen A, Cripps DJ, Bryan GT, Dogramaci I. Epidemiology of hexachlorobenzene porphyria in Turkey: clinical and laboratory follow-up after 25 years. Arch Neurol 39:744-749 (1982).
104. Gocmen A, Peters HA, Cripps DJ, Morris CR, Dogramaci I. Porphyria turcica: hexachlorobenzene-induced porphyria. In: Hexachlorobenzene: Proceedings of an International Symposium (Morris CR, Cabral JRP, eds). IARC Scientific Publications No 77, Lyon:International Agency for Research on Cancer, 1986;567-573.
105. Peters HA, Cripps DJ, Gocmen A, Erturk E, Bryan GT, Morris CR. Neurotoxicity of hexachlorobenzene-induced porphyria turcica. In: Hexachlorobenzene: Proceedings of an International Symposium (Morris CR, Cabral JRP, eds). IARC Scientific Publications No 77, Lyon:International Agency for Research on Cancer, 1986;575-579.
106. Peters H, Cripps D, Gocmen A, Bryan G, Erturk E, Morris C. Turkish epidemic hexachlorobenzene porphyria: a 30-year study. Ann NY Acad Sci 514:183-190 (1987).
107. Ockner RK, Schmid R. Acquired porphyria in man and rat due to hexachlorobenzene intoxication. Nature 189:499 (1961).
108. Elder GH, Evans JO, Matlin S. The porphyrinogenic action of polychlorinated hydrocarbons. In: Porphyrins in Human Diseases: First International Porphyrin Meeting (Doss M, ed). New York:S Karger, 1976;424-431.
109. San Martin de Viale LC, Rios de Molina MdC, Wainstok de Calmanovici R, Tomio JM. Experimental porphyria induced in rats by hexachlorobenzene: studies on the stepwise decarboxylation of uroporphyrinogen and phyriaporphyrinogen in vivo and in vitro in several tissues. In: Porphyrins in Human Diseases: First International Porphyrin Meeting (Doss M, ed). New York:S Karger, 1976;445-452.
110. de Matteis F. Experimental hepatic porphyria caused by hexachlorobenzene: mechanism of the metabolic block. In: Hexachlorobenzene: Proceedings of an International Symposium (Morris CR, Cabral JRP, eds). IARC Scientific Publications No 77, Lyon:International Agency for Research in Cancer, 1986;427-431.
111. Strik JJTWA. Subacute toxicity of hexachlorobenzene. In: Hexachlorobenzene: Proceedings of an International Symposium (Morris CR, Cabral JRP, eds). IARC Scientific Publications No 77, Lyon:International Agency for Research on Cancer, 1986;335-342.
112. Goldstein JA, Hickman P, Bergman H, Vos JG. Hepatic porphyria induced by 2,3,7,8-tetrachlorodibenzo-p-dioxin in the mouse. Res Commun Chem Pathol Pharmacol 6:919-928 (1973).
113. Goldstein JA, Linko P, Bergman H. Induction of porphyria in the rat by chronic versus acute exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Biochem Pharmacol 31:1607-1613 (1982).
114. Bleiberg J, Wallen M, Brodkin R, Appelbaum IL. Industrially acquired porphyria. Arch Dermatol 89:793-797 (1964).
115. Pazderova-Vejlupkova J, Nemcova M, Pickova J, Jirasek L, Lukas E. The development and prognosis of chronic intoxication by tetrachlordibenzo-p-dioxin in men. Arch Environ Health 36:5-11 (1981).
116. Hope W, Lischwe D, Russell W, Weiss S. Porphyria cutanea tarda and sarcoma in a worker exposed to 2,3,7,8-tetrachlorodibenzodioxin - Missouri. MMWR 33:113-114 (1984).
117. McConnell R, Anderson K, Russell W, Anderson KE, Clapp R, Silbergeld EK, Landrigan PJ. Angiosarcoma, porphyria cutanea tarda, and probable chloracne in a worker exposed to waste oil contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin. Br J Ind Med 50:699-703 (1993).
118. Poland AP, Smith D, Metter G, Possick P. A health survey of workers in a 2,4-D and 2,4,5-T plant; with special attention to chloracne, porphyria cutanea tarda, and psychologic parameters. Arch Environ Health 22:316-327 (1971).
119. Calvert GM, Sweeney MH, Fingerhut MA, Hornung RW, Halperin WE. Evaluation of porphyria cutanea tarda in U.S. workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Am J Ind Med 25:559-571 (1994).
120. Moses M, Lilis R, Crow KD, Thornton J, Fischbein A, Anderson HA, Selikoff IJ. Health status of workers with past exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin in the manufacture of 2,4,5-trichlorophenoxyacetic acid: comparison of findings with and without chloracne. Am J Ind Med 5:161-182(1984).
121. Doss M, Sauer H, von Tiepermann R, Colombi AM. Development of chronic hepatic porphyria (porphyria cutanea tarda) with inherited uroporphyrinogen decarboxylase deficiency under exposure to dioxin. Int J Biochem 16:369-373 (1984).
122. Centen AHJ, Strik JJTWA, Colombi A. Coproporphyrinuria and chronic hepatic porphyria type A found in people from Seveso (Italy) exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). In: Chemical Porphyria in Man (Strik JJTWA, Koeman JH, eds). Amsterdam:Elsevier, 1979;75-81.
123. Caputo R, Monti M, Ermacora E, Carminati G, Gelmetti C, Gianotti R, Gianni E, Puccinelli V. Cutaneous manifestations of tetrachlorodibenzo-p-dioxin in children and adolescents. J Am Acad Dermatol 19:812-819 (1988).
124. Caputo R. [Reply to letter]. J Am Acad Dermatol 21:1321 (1989).
125. Hoffman RE, Stehr-Green PA, Webb KB, Evans RG, Knutsen AP, Schramm WF, Staake JL, Gibson BB, Steinberg KK. Health effects of long-term exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. JAMA 255:2031-2038 (1986).
126. Webb K, Evans RG, Steht P, Ayres SM. Pilot study on health effects of environmental 2,3,7,8-TCDD in Missouri. Am J Ind Med 11:685-691 (1987).
127. Haberman HF, Rosenberg F, Menon IA. Porphyria cutanea tarda: comparison of cases precipitated by alcohol and estrogens. Can Med Assoc J 113:653-655 (1975).
128. Lynch RE, Lee GR, Kushner JP. Porphyria cutanea tarda associated with disinfectant misuse. Arch Intern Med 135:549-552 (1975).
129. Chalmers JNM, Gillam AE, Kench JE. Porphyrinuria in a case of industrial methyl chloride poisoning. Lancet 28:806-808 (1940).
130. Doss M, Lange CE, Veltman G. Vinyl chloride-induced hepatic coproporphyrinuria with transition to chronic hepatic porphyria. Klin Wochenschr 62:175-178 (1984).
131. Strik JJTWA, Doss M, Schraa G, Robertson LW, von Tiepermann R, Harmsen EGM. Coproporphyrinuria and chronic hepatic porphyria type A found in farm families from Michigan (USA) exposed to polybrominated biphenyls (PBB). In: Chemical Porphyria in Man (Strik JJTWA, Koeman JH, eds). Amsterdam:Elsevier, 1979;29-53.
132. Seki Y, Kawanishi S, Sano S. Mechanism of PCB-induced porphyria and Yusho disease. Ann NY Acad Sci 514:222-234 (1987).
133. Strik JJTWA, Kip H, Yoshimura T, Masuda Y, Harmsen EGM. Porphyrins in urine of Yusho patients. In: Chemical Porphyria in Man (Strik JJTWA, Koeman JH, eds). Amsterdam:Elsevier, 1979;63-68.
134. Nonaka S, Shimoyoma T, Honda T, Yoshida H. Analysis of urinary porphyrins in polychlorinated biphenyl poisoning (Yusho) patients. In: Chemical Porphyria in Man (Strik JJTWA, Koeman JH, eds). Amsterdam:Elsevier, 1979;69-73.
135. Nagelsmit A, van Vliet PW, van der Wiel-Wetzels WAM, Wielard MJ, Strik JJTWA, Ottevanger CF, van Sittert NJ. Porphyrins as possible parameters for exposure to hexachlorocyclopentadiene, allylchloride, epichlorohydrin and endrin. In: Chemical Porphyria in Man (Strik JJTWA, Koeman JH, eds). Amsterdam:Elsevier, 1979;55-61.
136. Rossi E, Costin KA, Garcia-Webb P. Effect of occupational lead exposure on lymphocyte enzymes involved in heme biosynthesis. Clin Chem 36:1980-1983 (1990).
137. Simons TJ. The affinity of human erythrocyte porphobilinogen synthase for Zn2+ and Pb2+. Eur J Biochem 234:178-183 (1995).
138. Wetmur JG, Kaya AH, Plewinska M, Desnick RJ. Molecular characterization of the human δ-aminolevulinate dehydratase 2 (ALAD2) allele: implications for molecular screening of individuals for genetic susceptibility to lead poisoning. Am J Hum Genet 49:757-763 (1991).
139. Battistuzzi G, Petrucci R, Silvagni L, Urbani FR, Caiola S. δ-aminolevulinate dehydrase: a new genetic polymorphism in man. Ann Hum Genet 45:223-229 (1981).
140. Petrucci R, Leonardi A, Battistuzzi G. The genetic polymorphism of D-aminolevulinate dehydrase in Italy. Hum Genet 60:289-290 (1982).
141. Benkmann HG, Bogdanski P, Goedde HW. Polymorphism of delta-aminolevulinic acid dehydratase in various populations. Hum Hered 33:62-64 (1983).
142. Ziemson B, Angerer J, Lehnert G, Benkmann HG, Goedde HW. Polymorphism of delta-aminolevulinic acid dehydratase in lead-exposed workers. Int Arch Occup Environ Health 58:245-247 (1986).
143. Astrin KH, Bishop DF, Wetmur JG, Kaul B, Davidow B, Desnick RJ. δ-aminolevulinic acid dehydratase isozymes and lead toxicity. Ann NY Acad Sci 514:23-29 (1987).
144. Wetmur JG, Lehnert G, Desnick RJ. The delta-aminolevulinate dehydratase polymorphism: higher blood lead levels in lead workers and environmentally exposed children with the 1-2 and 2-2 isozymes. Environ Res 56:109-119 (1991).
145. Smith CM, Wang X, Hu H, Kelsey KT. A polymorphism in the delta-aminolevulinic acid dehydratase gene may modify the pharmacokinetics and toxicity of lead. Environ Health Perspect 103:248-253 (1995).
146. Wetmur JG. Influence of the common human delta-aminolevulinate dehydratase polymorphism on lead body burden. Environ Health Perspect 102(Suppl 3):215-219 (1994).
147. Schwartz BS, Lee BK, Stewart W, Ahn KD, Springer K, Kelsey K. Associations of delta-aminolevulinic dehydratase genotype with plant, exposure duration, and blood lead and zinc protoporphyrin levels in Korean lead workers. Am J Epidemiol 142:738-745 (1995).
148. Doss M, von Tiepermann R. Urinary porphyrin profiles in acute lead poisoning: relation to differentiation from acute intermittent porphyria. In: Diagnosis and Therapy of Porphyrias and Lead Intoxication (Doss M, ed). New York:Springer-Verlag, 1978;178-184.
149. Doss M, Laubenthal F, Stoeppler M. Lead poisoning in inherited δ-aminolevulinic acid dehydratase deficiency. Int Arch Occup Environ Health 54:55-63 (1984).
150. Batlle AMdC, Fukuda H, Parera VE, Wider E, Stella AM. In inherited porphyrias, lead intoxication is a toxogenetic disorder. Int J Biochem 19:717-720 (1987).
151. Moore MR, Goldberg A, Yeung-Laiwah AAC. Lead effects on the heme biosynthetic pathway: relationship to toxicity. Ann NY Acad Sci 514:191-203 (1987).
152. Silbergeld EK. Role of altered heme synthesis in chemical injury to the nervous system. Ann NY Acad Sci 514:297-308 (1987).
153. Ishida N, Fujita H, Fukuda Y, Noguchi T, Doss M, Kappas A, Sassa S. Cloning and expression of the defective genes from a patient with δ-aminolevulinate dehydratase porphyria. J Clin Invest 89:1431-1437 (1992).
154. Doss M, Muller WA. Acute lead poisoning in inherited porphobilinogen synthase (δ-aminolevulinic acid dehydrase) deficiency. Blut 45:131-139 (1982).
155. Dyer J, Garrick DP, Inglis A, Pye IF. Plumboporphyria (ALAD deficiency) in a lead worker: a scenario for potential diagnostic confusion. Br J Ind Med 50:1119-1121 (1993).
156. Thunell S, Holmberg L, Lundgren J. Aminolaevulinate dehydratase porphyria in infancy: a clinical and biochemical study. J Clin Chem Clin Biochem 25:5-14 (1987).
157. Goldwater LJ, Joselow MM. Absorption and excretion of mercury in man. XIII: Effects of mercury exposure on urinary excretion of coproporphyrin and delta-aminolevulinic acid. Arch Environ Health 15:327-331 (1967).
158. Telolahy P, Javelaud B, Cluet J, de Ceaurriz J, Boudene C. Urinary excretion of porphyrins by smelter workers chronically exposed to arsenic dust. Toxicol Lett 66:89-95 (1993).
159. Garcia-Vargas GG, Garcia-Rangel A, Aguilar-Romo M, Garcia-Salcedo J, del Razo LM, Ostrosky-Wegman P, de Nava CC, Cebrian ME. A pilot study on the urinary excretion of porphyrins in human populations chronically exposed to arsenic in Mexico. Hum Exp Toxicol 10:189-193 (1991).
160. Downey D. Porphyria induced by palladium-copper dental prostheses: a clinical report. J Prosthet Dent 67:5-6 (1992).
161. Fowler BA, Oskarsson A, Woods JS. Metal-and metalloid-induced porphyrinurias: relationships to cell injury. Ann NY Acad Sci 514:172-182 (1987).
162. Bleakley P, Nichol AW, Collins AG. Diazinon and porphyria cutanea tarda. Med J Aust 1:314-315 (1979).
163. Tenhunen R, Savolainen H, Jappinen P. Changes in haem synthesis associated with occupational exposure to organic and inorganic sulphides. Clin Sci 64:187-191 (1983).
164. Peters HA, Cripps DJ, Reese HH. Porphyria: theories of etiology and treatment. Int Rev Neurobiol 16:301-355 (1974).
165. Silbergeld EK. Porphyrins as indicators of chemical injury and exposure. Ann NY Acad Sci 514:170-171 (1987).
166. Downey DC. Fatigue syndromes: new thoughts and reinterpretation of previous data. Med Hypotheses 39:185-190 (1992).
167. Downey DC. Fatigue syndromes revisited: the possible role of porphyrins. Med Hypotheses 42:285-290 (1994).
168. Downey DC. Hereditary coproporphyria. Br J Clin Pract 48:97-99 (1994).
169. Ziem G, Donnay A. Note with regard to the differential diagnosis of porphyrias and multiple chemical sensitivity. Baltimore:MOS Referral & Resources, December 1995.
170. Donnay A. Porphyria testing suggested for Gulf War veterans. In: Our Toxic Times, Vol 5. White Sulfur Springs, MT: Chemical Injury Information Network, December 1994;1,3.
171. Donnay A, Ziem G. Protocol for evaluating disorders of porphyrin metabolism in chemically sensitive patients. Baltimore:MCS Referral & Resources, March 1995.
172. Morton WE. Redefinition of abnormal susceptibility to environmental chemicals. In: Hazardous Waste: Impacts on Human and Ecological Health (Johnson BL, Xintaras C, Andrews JS Jr, eds). Princeton, NJ:Princeton Scientific Publishing, 1996;320-327.
173. Morton W. Chronic porphyrias' role in MCS. In: Our Toxic Times, Vol 6. White Sulfur Springs, MT:Chemical Injury Information Network, August 1995;22-24.
174. Duehring C. Porphyria and chronic fatigue. In: Our Toxic Times, Vol 6. White Sulfur Springs, MT:Chemical Injury Information Network, August 1995;17,19.
175. Duehring C. Environmental Access Profile: Porphyrinogenic chemicals and metabolism: MCS patients at risk. In: Our Toxic Times, Vol 6. White Sulfur Springs, MT:Chemical Injury Information Network, November 1995;9-11.
176. Duehring C. Environmental Access Profile: Porphyrinogenic pesticides: Toxic to all living things. In: Our Toxic Times, Vol 6. White Sulfur Springs, MT:Chemical Injury Information Network, December 1995;13,14.
177. Ziem G, McTamney J. Profile of patients with chemical injury and sensitivity. Environ Health Perspect Suppl (in press).
178. Sparks PJ, Daniell W, Black DW, Kipen HM, Altman LC, Simon GE, Terr AI. Multiple chemical sensitivity syndrome: a clinical perspective. I, Case definition, theories of pathogenesis, and research needs. J Occup Med 36:718-730 (1994).
179. Sparks PJ, Daniell W, Black DW, Kipen HM, Altman LC, Simon GE, Terr AI. Multiple chemical sensitivity syndrome: a clinical perspective. II, Evaluation, diagnostic testing, treatment, and social considerations. J Occup Med 36:731-737 (1994).
180. Daniell WE, Sparks PJ. Multiple chemical sensitivity syndrome. In: Environmental Respiratory Diseases (Cordasco EM Sr, Demeter SL, Zenz C, eds). New York:Van Nostrand Reinhold, 1995;391-417.
181. Cullen MR. The worker with multiple chemical sensitivities: an overview. Occup Med 2:655-661 (1987).
182. Simon GE, Daniell W, Stockbridge H, Claypoole K, Rosenstock L. Immunologic, psychological, and neuropsychological factors in multiple chemical sensitivity: a controlled study. Ann Intern Med 119:97-103 (1993).
183. Leavelle DE, ed. Mayo Medical Laboratories Interpretive Handbook: Interpretive Data for Diagnostic Laboratory Tests. Rochester, MN:Mayo Medical Laboratories, 1994.
184. Barnett RN. Normal values. In: Clinical Laboratory Statistics, 2nd ed. Boston:Little, Brown and Company, 1979;77-90.
185. Ransohoff DF, Feinstein AR. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med 299:926-930 (1978).
186. Charrow J, Hedges LV. When is a test result abnormal? Defining limits and risks. Am J Dis Child 144:245-250 (1990).
187. Richardson-Jones A, Twedt D, Gibson M, Fimlt NZ, Hellman R. Continuum analysis method applied to blood count reference intervals. Ann Clin Lab Sci 23:340-349 (1993).
188. Bottomley SS, Bonkowsky HL, Kreimer-Birnbaum M. The diagnosis of acute intermittent porphyria: usefulness and limitations of the erythrocyte uroporphyrinogen I synthase assay. Am J Clin Pathol 76:133-139 (1981).
189. Tefferi A, Colgan JP, Solberg LA Jr. Acute porphyrias: diagnosis and management. Mayo Clin Proc 69:991-995 (1994).
190. Peterson LR, Hamernyik P, Bird TD, Labbe RF. Erythrocyte uroporphyrinogen I synthase activity in diagnosis of acute intermittent porphyria. Clin Chem 22:1835-1840 (1976).
191. McColl KEL, Moore MR, Thompson GG, Goldberg A. Screening for latent acute intermittent porphyria: the value of measuring both leucocyte δ-aminolaevulinic acid synthase and erythrocyte uroporphyrinogen-1-synthase activities. J Med Genet 19:271-276 (1982).
192. Grandchamp B, Nordmann Y. Coproporphyrinogen III oxidase assay. Enzyme 28:196-205 (1982).
193. Guo R, Lim CK, Peters TJ. Accurate and specific HPLC assay of coproporphyrinogen III oxidase activity in human peripheral leucocytes. Clin Chim Acta 177:245-252 (1988).
194. Rossi E, Garcia-Webb P, Costin KA. Letter: Lymphocytes are the preferred cells for the measurement of blood coproporphyrinogen oxidase activity. Clin Chim Acta 181:115-118 (1989).
195. Sano S, Granick S. Mitochondrial coproporphyrinogen oxidase and protoporphyrin formation. J Biol Chem 236:1173-1180 (1961).
196. Pasanen AVO, Eklof M, Tenhunen R. Coproporphyrinogen oxidase activity and porphyrin concentrations in peripheral red blood cells in hereditary sideroblastic anaemia. Scand J Haematol 34:235-237 (1985).