Urinary Porphyrins in Disease

The structural chemistry of the blood and bile pigments has been developed by Hans Fischer and his school (l), but the physiological conditions which lead to the increased production of these pigments, especially of the porphyrins, are still uncertain. Although it is well known that in many diseases, notably those characterized by fever or liver injury (2), an increased excretion of porphyrins in the urine occurs, there are few data as to the kind of porphyrin excreted. From the study of the urinary porphyrins of congenital porphyrinuria and the scattered results of the few non-idiopathic porphyria which have been investigated, it is evident that only porphyrins derived from etioporphyrin I or III are to be expected in the urine (1, 3, 4). The question remains, however, as to what porphyrins are excreted in various diseases and what significance may be attached to their excretion. To answer the first of these questions the porphyrins from the urine of a variety of cases were isolated and characterized. Predominant among the diseases studied were those in which malfunction of the liver was the outstanding phenomenon.