Acute Porphyrias By Herbert L Bonkovsky, MD, Wake Forest University School of Medicine; Sean R Rudnick, MD, Wake Forest University School of Medicine Reviewed / Revised Dec 2022 View Patient Education Precipitating Factors Symptoms and Signs Diagnosis Prognosis Treatment Prevention Key Points More Information Acute porphyrias result from deficiency of certain enzymes in the heme biosynthetic pathway, resulting in accumulation of heme precursors that cause intermittent attacks of abdominal pain and neurologic symptoms.