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February 12, 1982

The Porphyria, Plumbism, Pottery Puzzle

JAMA. 1982;247(6):813-814. doi:10.1001/jama.1982.03320310061032

THE FOLLOWING article describes the solution to a fascinating porphyria, plumbism, pottery puzzle.

Report of a Case  In July 1978, while in California, a 41-year-old woman noted the gradual onset of pain in both knees, spreading to her feet and lower back over a period of weeks. In November, episodic vomiting, decreased appetite, and abdominal cramps developed. These symptoms led to hospitalization in December 1978. Family history was positive for chronic constipation in her father. There was moderate abdominal distention and tenderness without rebound tenderness. Bowel sounds were present, vibratory sensation was decreased in both feet, and ankle reflexes were absent. X-ray films of the abdomen revealed dilated bowel. Upper and lower gastrointestinal tract series revealed normal findings. Spinal fluid protein and glucose levels and cell counts were normal. The patient's hematocrit reading was 31%; hemoglobin level, 10 g/dL; corrected reticulocyte count, 3.7%; mean corpuscular volume, 94 cu μm; mean