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May 7, 1973

Possible Use of Vitamins C And/or E in Erythropoietic Protoporphyria

Author Affiliations

Department of Dermatology University of Nebraska Medical Center Omaha

JAMA. 1973;224(6):901-902. doi:10.1001/jama.1973.03220200057024

To the Editor.—  The current interest in therapeutic vitamin supplementation has produced a confused picture with respect to porphyria. As noted by Mustajoki in The Journal (221:714, 1972), the results of vitamin E therapy are contradictory. Thus, his group observed no clinical improvement in four patients with acute intermittent porphyria and one with variegate porphyria; whereas Nair et al1 reported the successful use of vitamin E in porphyria. Ludwig2 detected low tocopherol levels in persons with erythropoietic protoporphyria (EPP) and observed that the vitamin inhibited the in vitro photohemolysis of their red cells. This disease (EPP) is a good model for evaluating therapeutic agents, because it provides a sensitive in vivo criterion of efficacy (prevention of sunlight photosensitivity) as well as an in vitro standard (inhibition of erythrocyte photohemolysis). Provitamin A (β-carotene) has been employed successfully in EPP patients by Mathews-Roth et al.3 Although the rationale for