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An Unusual Cause of Headache and Fatigue in a Division 1 Collegiate Athlete.


ABSTRACT: Variegate porphyria (VP) is an autosomal dominant disorder of porphyrin metabolism. We report a case of a 21-year-old male collegiate athlete who complained of recurrent headache and fatigue. Extensive testing after initial presentation failed to identify a cause. Months later, his grandmother was diagnosed with VP after being hospitalized; hence, he was tested. He was positive for a heterozygous missense mutation, R168H, in one protoporphyrinogen oxidase allele. This case highlights a rare disorder of heme synthesis that should be considered in the differential diagnosis of exertional fatigue and headaches in athletes. When other more common causes of fatigue and/or headache are unable to be identified, a more focused history and examination may lead to a more unusual but crucial diagnosis. To our knowledge, there are no reported cases of this condition in Division I collegiate athletes.

SUBMITTER: Makki AY 

PROVIDER: S-EPMC5491239 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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An Unusual Cause of Headache and Fatigue in a Division 1 Collegiate Athlete.

Makki Ali Y AY   Leddy John J   Takano Koki K   Jain Rajiv R  

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 20170701 4


Variegate porphyria (VP) is an autosomal dominant disorder of porphyrin metabolism. We report a case of a 21-year-old male collegiate athlete who complained of recurrent headache and fatigue. Extensive testing after initial presentation failed to identify a cause. Months later, his grandmother was diagnosed with VP after being hospitalized; hence, he was tested. He was positive for a heterozygous missense mutation, R168H, in one protoporphyrinogen oxidase allele. This case highlights a rare diso  ...[more]

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