Q. My daughter and I have Porphyrias (enzyme deficiencies). I have peripheral and autonomic dysfunction but my daughter has an old diagnosis of ADD and a significant auditory processing learning disability. It is probably hereditary Coproporphyria which is the mildest of the three major neurological Porphyrias. My daughter claims she gets extremes in her mood from alcohol (now she knows it is contraindicated in porphyria), but she also had a very strange hyperactive reaction to trimethoprim sulfa at age three which is why I suspected she would have the porphyria I was diagnosed with. I wonder about comments on your questions and answers regarding autonomic instability especially with labile hypertension. Porphyrias can display mania with psychiatric symptoms. Perhaps more manic/depressives should be screened for porphyrias. I never had to go to a hospital for my abdominal pain which is supposed to be the big symptom in porphyria. Unfortunately too much of porphyria is based on following acute intermittent porphyrics and not variegate porphyria and hereditary coproporphyria. They may be different.

  A. I do not know enough about this to give you a good answer. The incidence of Porphyrias (enzyme deficiencies) is pretty low, so while it may help to screen in some cases, overall it would have a very low yield.