Lead poisoning mimicking acute porphyria!

We are presenting a case of a 13-year-old autistic boy whose urine porphyrin test came positive on three separate occasions. The child was brought to emergency department of Kasturba Medical College Hospital, Attavar, Mangalore, India, with fever and acute abdominal pain, with no previous history of any serious illness. Investigations revealed thalassemia trait,microcytic hypochromic anaemia while the other biochemical and haematological parameters were normal. False positive urine porphyrin test may be seen in porphyria induced by liver cancer, hepatitis and heavy metal poisoning such as lead, arsenic and mercury. Blood lead (PbB) level was 59.5μg/dl. Further evaluation revealed a daily consumption of native medicine in the form of syrup.