1. A 24 years old lady came to the ER with bullous eruptions on her skin. It was May month and very sunny outside and she had gone out in the sun. She had recently started a prescription of oral contraceptives. On examination in the ER she was found to be disoriented to time and place. Her blood pressure was found to be 180/90 mmHg. Which of the following statements is false?
1. This disorder is autosomal dominant
2. The abnormality lies in the heme biosynthesis pathway
3. There are anti basement membrane antibodies
4. The oral contraceptives have a role to play in the pathogenesis of this disorder.

Answer: The answer is (c). This is a case of variegate porphyria. All the porphyrias are defects in the biosynthetic pathway of heme. Variegate porphyria is autosomal dominant and is characterized by bullous eruptions of the skin. Also associated are features of acute intermittent porphyria namely, disorientation, polyneuropathy, hypertension and abdominal pain.