<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0138-6557</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina Militar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cub Med Mil]]></abbrev-journal-title>
<issn>0138-6557</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias MédicasEditorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0138-65572021000400031</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Alternativas diagnósticas y terapéuticas para las porfirias hepáticas agudas en adultos, desde una perspectiva actual]]></article-title>
<article-title xml:lang="en"><![CDATA[Diagnostic and therapeutic alternatives for acute hepatic porphyrias in adults from a current perspective]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Algarín-Lara]]></surname>
<given-names><![CDATA[Holmes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Osorio-Rodríguez]]></surname>
<given-names><![CDATA[Elber]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Patiño-Patiño]]></surname>
<given-names><![CDATA[Jhonny]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tavera-Medina]]></surname>
<given-names><![CDATA[Angie]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guevara-Romero]]></surname>
<given-names><![CDATA[Edwin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Camino Universitario Distrital Adelita de Char  ]]></institution>
<addr-line><![CDATA[ Barranquilla]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario de la Samaritana  ]]></institution>
<addr-line><![CDATA[ Bogotá]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Metropolitana de Barranquilla  ]]></institution>
<addr-line><![CDATA[ Barranquilla]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Wisconsin-Madison  ]]></institution>
<addr-line><![CDATA[ Madison]]></addr-line>
<country>EE.UU</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>50</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0138-65572021000400031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0138-65572021000400031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0138-65572021000400031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Las porfirias hepáticas agudas son un trastorno genético causado por actividad irregular en la síntesis del grupo hemo. Aunque son de baja incidencia, su presencia puede aumentar el riesgo de muerte y afectar la calidad de vida de los pacientes. Se realizó una búsqueda bibliográfica con un intervalo desde el año 2015 al 2020, sobre porfirias hepáticas agudas.  Objetivos:  Actualizar sobre las alternativas diagnósticas y terapéuticas para las porfirias hepáticas agudas en adultos.  Desarrollo: La exposición a ciertos factores precipitantes como fármacos, infecciones y estrés, conllevan a una crisis aguda de porfiria, que desencadenan síntomas neuroviscerales y requiere hospitalización. Existen teorías aisladas que explican el mecanismo de daño durante el ataque agudo, como la hiperactividad autónoma, inflamación, disfunción endotelial, mitocondrial, lesión renal y neurotoxicidad. Sin embargo, el reconocimiento clínico de estos mecanismos sin un diagnóstico conocido de porfiria es un reto para el personal médico, debido a la presencia de síntomas y signos inespecíficos, lo que retrasa el diagnóstico. Debido a la dependencia de la hemina de por vida, se han optado por nuevas alternativas terapéuticas como la supresión genética y el trasplante hepático. El pronóstico es favorable cuando se realiza el diagnóstico a tiempo.  Conclusiones: Las alternativas diagnósticas y terapéuticas para las porfirias hepáticas agudas en adultos han evolucionado hacia el trasplante ortotópico hepático y la terapia génica, la cual se ha convertido en un enfoque terapéutico prometedor y validado para el tratamiento de los pacientes con porfirias hepáticas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Acute hepatic porphyria is a genetic disorder caused by irregular activity in the synthesis of the heme group. Although they are of low incidence, their presence can increase the risk of death and affect the quality of life of patients. A bibliographic search was carried out with a time interval from 2015 to 2020 on acute hepatic porphyria.  Objectives:  To update on the diagnostic and therapeutic alternatives for acute hepatic porphyria in adults.  Development:  Exposure to certain precipitating factors such as drugs, infections, and stress leads to an acute porphyria crisis, which triggers neurovisceral symptoms and requires hospitalization. There are isolated theories that explain the mechanism of damage during the acute attack, such as autonomic hyperactivity, inflammation, endothelial and mitochondrial dysfunction, kidney damage, and neurotoxicity. However, clinical recognition of these mechanisms without a known diagnosis of porphyria is challenging for medical personnel, due to the presence of nonspecific symptoms and signs, delaying diagnosis. Due to the dependence on hemin for life, new therapeutic alternatives such as gene suppression and liver transplantation have been chosen. The prognosis is favorable when the diagnosis is made in time.  Conclusion: Diagnostic and therapeutic alternatives for acute hepatic porphyria in adults have evolved towards orthopedic liver transplantation and gene therapy, which has become a promising and validated therapeutic approach for the treatment of patients with hepatic porphyria.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[porfirias hepáticas]]></kwd>
<kwd lng="es"><![CDATA[hemo]]></kwd>
<kwd lng="es"><![CDATA[hemina]]></kwd>
<kwd lng="es"><![CDATA[enfermedades genéticas]]></kwd>
<kwd lng="en"><![CDATA[hepatic porphyria]]></kwd>
<kwd lng="en"><![CDATA[hemo]]></kwd>
<kwd lng="en"><![CDATA[hemin]]></kwd>
<kwd lng="en"><![CDATA[genetic diseases]]></kwd>
</kwd-group>
</article-meta>
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