Fine needle aspiration biopsy smears from 19 patients with porphyria cutanea tarda were studied by fluorescence microscopy. Fluorescence was arbitrarily graded from 0 to 4. All patients—those with clinically manifest as well as those with latent disease—showed bright red fluorescence of porphyrin type in the liver cells, though in latent cases the fluorescence commonly was of a low grade. In patients with manifest disease fluorescence of grade 3 or 4 was present.
In patients with fluorescence of grades 1 or 2 the uroporphyrin excretion in urine was normal or slightly increased. At higher grades all levels of porphyrin excretion were encountered.
Of 22 control subjects, only one showed hepatic fluorescence of a porphyrin character. The control patient with a positive finding was found to have definitely increased urinary uroporphyrin excretion and probably has latent porphyria cutanea tarda.
The procedure described should be useful as a screening test for hepatic cutaneous porphyria.
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