Accreditation/Credit Designation

Physicians’ Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians’ Education Resource®, LLC, designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians’ Education Resource®, LLC, is approved by the California Board of Registered Nursing, Provider #16669, for 1.5 contact hours.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.

Online Case Investigations: Multidisciplinary Evaluations of Acute Hepatic Porphyria - How Can We Improve Recognition and Treatment?

Release Date: January 15, 2021
Expiration Date: January 15, 2022

Activity Overview

Acute hepatic porphyria (AHP) is a rare genetic disease associated with the heme biosynthetic pathway of the liver. AHP is caused by enzymatic defects that result in the accumulation of toxic intermediates in the liver. It can present clinically in the form of acute neurovisceral attacks characterized by neuropathic pain, mostly abdominal, and may be accompanied by muscular pain, nausea, vomiting, constipation, general malaise, fatigue, as well as psychiatric and neurological symptoms. Because AHP symptoms are nonspecific, they are often misdiagnosed as those of other, more common conditions, and are therefore, not adequately treated. These nonspecific symptoms may also lead to unnecessary, ineffective surgical interventions, such as appendectomy, cholecystectomy, and hysterectomy. Nonspecific symptoms, coupled with nondiagnostic evaluations, result in a mean delay in diagnosis of approximately 15 years.

This Online Case Investigations format has been specifically designed to increase knowledge and competence surrounding rare and ultrarare diseases. Considering how the symptoms of AHP often resemble those of other diseases that may be evaluated by neurologists, gastroenterologists, emergency department physicians, and OB-GYNs, educating these health care providers about the pathophysiology, signs and symptoms, proper diagnosis, and optimal treatment of AHP is of utmost importance. This format includes in-depth, challenging patient cases in each of these respective practices, as an extremely effective way to ensure that patients with AHP can be diagnosed and treated in a safe, timely manner. .

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.

Instructions for This Activity and Receiving Credit

  1. Complete the activity (including pre- and post-activity assessments).
  2. Answer the evaluation questions.
  3. Request credit using the drop-down menu.

You may immediately download your certificate.

Target Audience

This educational activity is directed toward hepatologists, gastroenterologists, OB-GYNs, neurologists, emergency department physicians, and primary care physicians who treat patients with AHP. Other health care professionals interested in the treatment of AHP are invited to participate.

Learning Objectives

Upon successful completion of this activity, you should be better prepared to:

  • Review the epidemiology, risk factors, and pathophysiology of AHP
  • Analyze and assess the symptomatology and diagnosis of AHP
  • Evaluate the latest data on the efficacy and safety of current AHP therapies and the importance of a multidisciplinary team

Faculty, Staff, and Planners’ Disclosures

In accordance with ACCME Guidelines, PER® has identified and resolved all COI for faculty, staff, and planners prior to the start of this activity by using a multistep process.


Herbert L. Bonkovsky, MD
Herbert L. Bonkovsky, MD
Professor of Medicine and Molecular Medicine and Translational Science
Director of Laboratory for Liver & Metabolic Disorders
Wake Forest University School of Medicine/Wake Forest Baptist Health
Winston-Salem, NC
Health Consultants of New England, LLC
Charlotte, NC

Disclosures: Grant/Research Support (to institution): Alnylam Pharmaceuticals; Gilead Sciences; Mitsubishi-Tanabe, NA; Recordati Rare Diseases; Consultant: Alnylam Pharmaceuticals; Disc Medicine; Mitsubishi-Tanabe NA; Recordati.

Vera Bril, MD
Vera Bril, MD
Professor of Neurology, University of Toronto
Director Neuromuscular Section, Division of Neurology, University of Toronto
Director, Ellen & Martin Prosserman Centre for Neuromuscular Diseases
University Health Network
Toronto, Canada

Disclosures: Consultant: Alnylam Advisory Board.

Janelle K. Moulder, MD, MSCR, FACS, FACOG
Janelle K. Moulder, MD, MSCR, FACS, FACOG
Assistant Professor, Wake Forest School of Medicine
Wake Forest Baptist Health, Department of Obstetrics and Gynecology, General Gynecology
Winston-Salem, NC

Disclosures: Janelle K. Moulder, MD, MSCR, FACS, FACOG has no relevant financial relationships with commercial interests.

Rachel Waldron, MD
Rachel Waldron, MD
Emergency Physician
Georgia Emergency Associates
Savannah, GA A

Disclosures: Rachel Waldron, MD has no relevant financial relationships with commercial interests.

Bruce Wang, MD
Bruce Wang, MD
Assistant Professor
Division of Gastroenterology
Department of Medicine
University of California San Francisco
San Francisco, CA A

Disclosures: Grant/Research Support (to institution): Alnylam Pharmaceuticals Consultant: Alnylam Pharmaceuticals; Recordati Rare Diseases.

The staff of Physicians' Education Resource®, LLC (PER®) have no relevant financial relationships with commercial interests to disclose.

Off-Label Disclosure and Disclaimer

This activity may or may not discuss investigational, unapproved, or off-label use of drugs. Learners are advised to consult prescribing information for any products discussed. The information provided in this accredited activity is for continuing education purposes only and is not meant to substitute for the independent clinical judgment of a healthcare professional relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER® or any company that provided commercial support for this activity.

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