Porphyria: a new perspective.

Recently, Medical Hypotheses has published two papers on fatigue syndromes and their relationship to porphyrin metabolism (1,2). This article continues the exploration of how many diseases may have abnormal porphyrin metabolism playing a role in their pathogenesis. Another issue is the need to expand our concepts of the frequencies of these genetic enzyme deficiencies in this pathway. Over time and the development of better tests, the identification of porphyric patients has increased (3). Now that more enzymes are becoming available for testing, the use and interpretation of those tests becomes critical and the selection of control populations could greatly affect results.