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We report a new method for obtaining urinary and faecal porphyrin excretion patterns in human porphyrias based on fast atom bombardment mass spectrometry (FAB-MS). Porphyrins were esterified and extracted from urine or faeces as their methyl esters for analysis by FAB-MS. The protonated pseudo-molecular ion [M + H]+ observed for each porphyrin is characteristic of that porphyrin, thus allowing a mixture of porphyrins to be analysed without the need for chromatographic separation. By using tandem MS, identification and characterisation of unknown porphyrins can be achieved. The urinary and faecal porphyrin excretion patterns from various porphyric patients obtained by FAB-MS are in good agreement with those analysed by TLC or HPLC methods.

A reversed-phase high-performance liquid chromatographic method is described for the determination of hydroxy and peroxy acid derivatives of uroporphyrin in the plasma of patients with congenital erythropoietic porphyria. The porphyrins were extracted from the plasma with 20% trichloroacetic acid-dimethyl sulphoxide (1:1, v/v). The supernatant after centrifugation was chromatographed on a Hypersil-ODS column by gradient elution with 9% (v/v) acetonitrile in 1 M ammonium acetate buffer (pH 5.16) (solvent A) and 10% (v/v) acetonitrile in methanol (solvent B) as the gradient mixture. The method was also suitable for the preparative isolation of the porphyrins.

A new porphyrin, peroxyacetic acid uroporphyrin I, has been isolated from the urine of patients with congenital erythropoietic porphyria by reversed phase high performance liquid chromatography. The porphyrin was characterized by high resolution mass spectrometry and by typical chemical reactions of a peroxyacid.

beta-Hydroxypropionic acid- and hydroxyacetic acid-uroporphyrin I have been isolated from the urine of a patient with congenital erythropoietic porphyria by reversed phase high performance liquid chromatography. The compounds were characterized by their chemical behaviour and confirmed by liquid secondary ion mass spectrometry.

The analysis of faecal and urinary porphyrins by high pressure liquid chromatography (H.P.L.C.) provides characteristic profiles and facilitates rapid diagnosis of variegate (porphyria cutanea tarda hereditaria), symptomatic porphyria (porphyria cutanea tarda symptomatica), hereditary coproporphyria, acute intermittent porphyria, erythro-hepatic protoporphyria and congenital porphyria (erythropoietic porphyria).

We report the case of a woman with hereditary porphyria cutanea tarda which manifested 3 weeks after she gave birth to her second child. The mother of the patient had also been diagnosed and treated for porphyria cutanea tarda. Reduced red cell uroporphyrinogen decarboxylase activity was found in the patient, the new-born child and the patient's mother. Normal enzyme activity was found in the patient's first child.

A new porphyrin, meso-hydroxyuroporphyrin I, was isolated from the urine of a patient with congenital erythropoietic porphyria. The structure was characterized as the methyl ester, ethyl ester and acetoxy derivatives by fast-atom-bombardment m.s., by conversion into uroporphyrin I and by chemical synthesis.

A 13-year-old boy who had had recurrent photosensitive skin reactions due to erythropoietic protoporphyria from 18 months of age, suddenly developed rapidly progressive hepatic failure with increasing cholestatic jaundice and variceal bleeding. Liver biopsy confirmed extensive protoporphyrin deposition with cirrhosis, and so orthotopic liver transplantation was performed. Postoperatively his skin rash settled within 72 hr, and in spite of subsequent exposure to the sun he has had no further skin reaction or blistering, although he does still have some itching. He made a good recovery and was able to return to school within six months of operation. Prior to liver transplantation, the hepatic ferrochelatase activity was reduced to only 0.81 nmol zinc-protoporphyrin formed/mg protein/hr (controls 3.30 +/- 1.00 nmol zinc-protoporphyrin formed/mg protein/hr, while the red cell protoporphyrin level was markedly elevated at 188 mumol/L red cells (normal less than 1.6 mumol/L red cells). The free plasma porphyrin level of 0.95 mumol/L (normal less than 0.02 mumol/L), and the urinary and fecal porphyrin levels were also raised. Following liver grafting these elevated porphyrin levels fell rapidly, with the red cell protoporphyrin level dropping to 10% of its preoperative value, and the rest returning to virtually normal within three months of operation.

A novel reversed-phase system is described for the simultaneous separation of type I and type III isomers of uro-, heptacarboxylic-, hexacarboxylic -, pentacarboxylic - and copro -porphyrins and the dicarboxylic meso- and proto-porphyrins. The porphyrins were resolved on a Hypersil -SAS column eluted with 10% (v/v) acetonitrile in 1 mol/l ammonium acetate, pH 5.16 (solvent A) and 10% (v/v) acetonitrile in methanol (solvent B) with a linear gradient from 100% A (0%B) to 35% A (65%B) in 30 min followed by isocratic elution at 65% B for a further 10 min. The method is simple and reproducible and has been applied to the analysis of porphyrins in urine and faeces from patients with acute intermittent, variegate, hereditary copro , congenital erythropoietic, erythrohepatic proto and symptomatic porphyrias.

A case of pseudoporphyria associated with excessive consumption of brewers ' yeast was studied. Detailed analysis of the yeast tablets by high performance liquid chromatography showed the presence of dicarboxylic deuteroporphyrin , mesoporphyrin, and protoporphyrin; coproporphyrin I and III isomers; and uroporphyrin I and III isomers. The faecal porphyrin concentration of the patient taking yeast tablets was significantly increased, resembling the excretion pattern in variegate porphyria. Any patient showing an unusual porphyrin excretion pattern on high performance liquid chromatography should be investigated for a possible dietary cause.