Abstract
We describe a 62-year-old man who developed porphyria cutanea tarda (PCT) and viral hepatitis (type C) while on chronic hemodialysis. About two years after the start of hemodialysis therapy, the patient complained of increasing skin pigmentation, multiple bullous changes and skin ulcers in areas exposed to light. As the erythrocyte coproporphyrin and protoporphyrin concentrations were extremely high, we made a diagnosis of aggravation of PCT. From December 1992 to July 1993, we treated the patient with hemodiafiltration (HDF) using a high-performance membrane (HPM) dialyzer by the post-dilution method with 10 liters of fluid, once a week by regular hemodialysis. Within 1 month of the start of HDF, his skin pigmentation decreased and the bullous changes and ulcers had improved as the erythrocyte porphyrin level decreased. These findings suggested that other factors, such as hemodialysis or C type hepatitis, may have aggravated his PCT besides the genetic factor. Furthermore, it PCT was successfully treated by HDF using a HPM dialyzer.
