home past issue about ip about iap feedback links  author info.   subscription correspondence indian pediatrics 2008; 45:865-866 congenital erythropoietic porphyria congenital erythropoietic porphyria (cep) is a rare cutaneous pophyria which presents with photosensitivity, complicated by presence of hemolytic anemia. Viagra original von lilly There is no permanent cure and the treatment is supportive. buy cheap viagra no prescription A 3 day-old male baby was admitted with neonatal jaundice for phototherapy. generic viagra shipping from canada The baby developed bullous lesions over both the feet within minutes of starting phototherapy( fig. buy viagra online usa no prescription 1). These lesions were prominently present over the toes and were filled with clear fluid. viagra for men sale We observed the color of the urine to be pink. viagra use timing The baby had no hepatosplenomegaly or any evidence of hemolysis. A urine analysis showed the presence of uroporphyrin and coproporphyrin which are not usually detectable suggesting the diagnosis of cep. buy viagra in us A quantitative assay could not be done because of financial reasons. buy viagra canada paypal The lesions healed in 2 weeks time following which the patient was discharged with advice regarding photoprotection and regular follow up. buy viagra The patient is now 3 months old and has not had any further episodes of blister formation. Fig. generic viagra 1 edematous lower limbs with scars of surgery. viagra daily use price Note also the swelling of the interphalangeal joints of the great toes. viagra without a doctor prescription overnight delivery Cep, also known as gunther’s disease, is an autosomal recessive inherited deficiency of the uroporphyrinogen iii cosynthetase enzyme leading to accumulation of type i porphyrins. Less than a hundred cases are reported worldwide(1). The earliest sign of cep could be brownish discoloration of amniotic fluid or pink to brown staining of the nappies. buy viagra from canada Severe photosensitivity often begins in the neonatal period itself with blisters developing on exposure to light. buy liquid viagra online There have been earlier case reports of cep in which the newborns developed photosensitivity following phototherapy but in most of these newborns hemolytic anemia was the main presenting feature(2,3). Viagra overdose warning There are reports of older children and adults with cep from india also(4,5). Would viagra affect women Genetic counseling is important for the parents of an affected offspring. buy liquid viagra online Antenatal diagnosis can be made by measuring the uroporphyrin i concentration in the amniotic fluid which is increased as early as 16 weeks in utero. buy liquid viagra online Diagnosis is made. can buy viagra spain over counter buying viagra online