Burning. [16], If all the porphyrin studies are negative, one must consider pseudoporphyria. She is one of sixteen people to win a Grammy, Academy, Emmy, and Tony Award. Later, Nancy Garden argued for a connection between porphyria and the vampire belief in her 1973 book, Vampires. Both suffered documented attacks that could be described as symptoms of porphyria. [5] The underlying mechanism was first described by German physiologist and chemist Felix Hoppe-Seyler in 1871. Each step is catalyzed by a separate enzyme. This causes local skin damage. In. [1] The disease was described as early as 370 BC by Hippocrates. Filed Under: Medical Articles and Infographics, 2023 HealthResearchFunding.org - Privacy Policy, 14 Hysterectomy for Fibroids Pros and Cons, 12 Pros and Cons of the Da Vinci Robotic Surgery, 14 Pros and Cons of the Cataract Surgery Multifocal Lens, 11 Pros and Cons of Monovision Cataract Surgery. There are at least eight types of porphyria, which vary substantially in their symptoms and severity. 4. [citation needed], Any sign of low blood sodium (hyponatremia) or weakness should be treated with the addition of hematin, heme arginate, or even tin mesoporphyrin, as these are signs of impending syndrome of inappropriate antidiuretic hormone (SIADH) or peripheral nervous system involvement that may be localized or severe, progressing to bulbar paresis and respiratory paralysis. In congenital erythropoietic porphyria (CEP), one of the rarest forms, 18 different mutations in the gene encoding the enzyme uroporphyrinogen III cosynthase have been reported in different families. This accounts for the property of fluorescence typical of the porphyrins. Weakness or paralysis, numbness, tingling, and muscle pain are other signs of porphyria. Depression is part and parcel of the Acute Porphyrias. A top-performing employee for months might turn into an irritable, self-absorbed handful for a stretch of time, work well for many more months and then lose the ability to fully function in the midst of a deep depression. Contemporaries often remarked on the Great Emancipators sorrow. In the United Kingdom, supplies of NormoSang are kept at two national centers; emergency supply is available from St Thomas's Hospital, London. Even in his insanity he never forgot his exalted status, although he ceased to shave and now had a long white beard, he always wore a purple dressing gown with his Garter star pinned to his chest. Moran prescribed amphetamines for Churchill in later years for his depressive episodes and a barbituate from 1940 to help him sleep. There are several different types of porphyria that are known and all vary in severity. Fewer than 300 cases have been reported in the medical literature of Congenital Eyrthropoeitic Porphyria. 4. In: Neurology in Clinical Practice, 6th Edition. Likewise, people suffering from porphyria will feel constant abdominal pains, will have increased hair growth, bouts of vomits and tightened skin. Her daughter, Princess Feodora of Saxe-Meiningen (born 19 May 1879) is also claimed to have suffered from the disease. One of the more common types of the disease is acute intermittent porphyria (AIP), which famously afflicted the unfortunate King George III of Britain--the "mad king" of Alan Bennetts play. It is not unusual for someone to be IV fasting after a surgery for several days to have porphyria symptoms develop. Signs and symptoms of porphyria vary, depending on the specific type and severity. . "Sometimes the road less traveled is less traveled for a reason." Jerry Seinfeld (February 1997) 4. Defects in any of these can lead to some form of porphyria. He called the condition pempigus leprosus. A portrait of Samuel Johnson by Joshua Reynolds. Most kinds of sunscreen are not effective, but SPF-rated long-sleeve shirts, hats, bandanas, and gloves can help. The level of depression will affect everyone differently. It affects about 1 in 25,000 people in the UK. [citation needed], Given the many presentations and the relatively low occurrence of porphyria, patients may initially be suspected to have other, unrelated conditions. She later developed a pain in her chest, before going into convulsions. In most cases, some degree of normality can be restored within a few days of an attack. George III. This is a rare disorder that mainly affects the skin. There are high incidence reports of AIP in areas of India and Scandinavia. In EPP there is excess production of protoporphyrin by developing red blood cells in the bone marrow. The chronicler Plutarch describes Caesar as being afflicted with distemper in the head and notes that he once fell into a fit in which his body trembled, and some of the papers he held dropped out of his hands. Suetonius, meanwhile, says Caesar was struck by a similar sickness on two different occasions during his military campaigns. The links between porphyrias and mental illness have been noted for decades. [2] Porphyria cutanea tarda is believed to be the most common type. 2023 A&E Television Networks, LLC. So do many of our most famous leaders, notably Theodore Roosevelt, Winston Churchill, and General Patton. In CEP, the genetic fault affects the stem cells in the bone marrow, which divide to produce new red blood cells. Exactly which porphyrins accumulate depends on the site of the jam, and it is this that gives porphyria such a wide range of symptoms. It is due to a deficiency in the enzyme protoporphyrinogen oxidase (PPOX). 1. [5] The name porphyria is from the Greek , porphyra, meaning "purple", a reference to the color of the urine that may be present during an attack. Paraplegia is an impairment which causes paralysis in the lower limbs. George Clooney, actor and star of movies like "Up in the Air" and the "Ocean's Eleven" series was diagnosed with Bell's palsy when he was a 14. seventh edition. Macalpine concluded that all those symptoms added up to a mild case of porphyria. Bill Gates (1955 - ) American businessman, founder of Microsoft. It seems likely that this disorder is the origin of the vampire myth. Bone-marrow transplants have been carried out successfully in at least five children with CEP, usually within the first few years of life. Porphyria cutanea tarda (PCT) is a type of porphyria or blood disorder that affects the skin. Porphyria cutanea tarda affects people around the world and isn't limited to a particular region or country. [38], Pain is severe, frequently out of proportion to physical signs, and often requires the use of opiates to reduce it to tolerable levels. Though slow in its onset, the disorder is known to cause changes in skin color during its late stages, which may explain Austens claims that her complexion had turned black and white and every wrong color. Other scholars maintain that the novelists symptoms appeared far too sporadically to be Addisons disease, and instead argue that she may have suffered from tuberculosis, lymphoma or even arsenic poisoning. 7. (Put to medical use, drugs containing porphyrins can attack tumors and other ailments. This is basically a dramatic monologue written about love and some melodramatic features also can be found here. The specific names of the eight types of porphyrias are: Delta-aminolevulinate-dehydratase deficiency porphyria Acute intermittent porphyria Hereditary coproporphyria Variegate porphyria Congenital erythropoietic porphyria Porphyria cutanea tarda Hepatoerythropoietic porphyria Erythropoietic protoporphyria The products of the earlier steps, porphyrin intermediates, may build up to toxic levels. Use them in commercial designs under lifetime, perpetual & worldwide rights. Though Charlotte seemed at first to be recovering well from her horrendous ordeal, she complained that evening of severe stomach pains and began to vomit. Maria I of Portugal in a c. 1790s portrait attributed to Giuseppe Troni or Thomas Hickey. If absolutely necessary, patients should use the medications with the shortest course in case of an attack. 4 However, more recent studies have suggested that acute crises are rarely fatal. Porphyrias are a group of eight NMDs causing intermittent neuro-visceral and cutaneous attacks, concomitant or isolated. Vector illustration for medical. Find out which celebrities, athletes or public figures have Porphyria. Porphyria is an inherited blood disorder that causes the body to produce less heme a critical component of hemoglobin, the protein in red blood cells that carries oxygen from the lungs to the. One of the more common types of the disease is acute intermittent porphyria (AIP), which famously afflicted the unfortunate King George III of Britain--the "mad king" of Alan Bennetts play. Left figure is urine on the first day while the right figure is urine after three days of sun exposure showing the classic change in color to purple. ", "Lead Poisoning Can Be Easily Misdiagnosed as Acute Porphyria and Nonspecific Abdominal Pain", "What Tests Can Help Diagnose Porphyria? Children have a 50% chance of inheriting any of the 8 different types of Porphyria if their parents have the disorder. Known for restoring the reputation of a monarchy tarnished by the extravagance of her predecessors The technique has been shown to be effective in cell culture, but there is still a long way to go before gene therapy for CEP can be used in clinical practice. Porphyrias are classified in two ways, by symptoms and by pathophysiology. Make a Gift. People demanded those methods because extravagant cases like the one about Angelo Hays's gained fame. [33], Repeat testing during an attack and subsequent attacks may be necessary in order to detect a porphyria, as levels may be normal or near-normal between attacks. [29], Porphyria is diagnosed through biochemical analysis of blood, urine, and stool. Number of people. Taking a drug used to treat malaria hydroxychloroquine (Plaquenil) or, less often, chloroquine (Aralen) to absorb excess porphyrins and help your body get rid of them more quickly than usual. Individuals with congenital erythropoietic porphyria do not crave blood. Mary's son James I and VI is also often cited as suffering from the condition. In that case, certain conditions or actions can trigger symptoms of porphyria. Estrogen use by women. Fewer than 300 cases have been reported in the medical literature of Congenital Eyrthropoeitic Porphyria. (You probably know him as Vlad the Impaler or Vlad Dracula, the inspiration for Bram Stokers Dracula.) From left to right: Alice, Arthur, Prince Albert, Albert Edward, Leopold, Louise, Queen Victoria with Beatrice, Alfred, Victoria, and Helena. The exception to this may be latent post-puberty genetic carriers of hereditary coproporphyria. On exposure to sunlight the leaves blister, and eventually wither and die. He ruled Walachia, Romania, off and on from 1456-1462.. 55 Fruit Street. The most common erythropoietic porphyria, erythropoietic protoporphyria (EPP), is estimated to have a prevalence rate of 1 in 50,000 to 1 in 75,000. These diseases primarily affect the nervous system, resulting in episodic crises known as acute attacks. In January 1964, L. Illis's 1963 paper, "On Porphyria and the Aetiology of Werewolves," was published in Proceedings of the Royal Society of Medicine. Symptoms vary greatly and can include abdominal pain, nervous system problems, mental health problems and skin problems. [37], Heme arginate (NormoSang) is used during crises but also in preventive treatment to avoid crises, one treatment every 10 days. 5 In people with protoporphyria, bile carries extra porphyrins from the liver to the gallbladder, which may lead to gallstones that are made of porphyrins. [39], Patients who experience frequent attacks can develop chronic neuropathic pain in extremities as well as chronic pain in the abdomen. Longer-acting medications can be . All Rights Reserved. [2] Complications may include paralysis, low blood sodium levels, and seizures. Second, the extra heme suppresses further heme synthesis via a negative feedback loop. People with porphyria should, therefore, avoid medications as much as possible, including recreational drugs such as cannabis. Pain. He was subjected to the appalling medical treatment of the day, bound and gagged and strapped into a chair for hours. When experiencing a porphyria attack, it is not uncommon for their to be eyesight blurring or other changes that occur because of a dysfunction in the nervous system. Pain treatment with long-acting opioids, such as morphine, is often indicated, and, in cases where seizure or neuropathy is present, gabapentin is known to improve outcome. 2. Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.) In fact, in the majority of cases, people who test positively . She went into labour on 3rd November 1817, the birth proved to be difficult and protracted, Caroline's ordeal lasted for fifty hours. Studies of the animals could yield clues that would be useful in fighting CEP. However, levels of some porphyrins may be normal in people with porphyria who do not have current symptoms. Treatment can be problematic: barbiturates especially must be avoided. All the versions of porphyria have one thing in common: they each result from faults in the bodys heme-building machinery. Butterworth Heinemann. Acute Hepatic Porphyria (AHP, also known as Acute Porphyria) refers to a family of rare genetic diseases characterized by potentially life-threatening attacks and, for some people, chronic (ongoing and sometimes lifelong) pain and other symptoms that interfere in their ability to live normal lives. Porphyria has been suggested as an explanation for the origin of vampire and werewolf legends, based upon certain perceived similarities between the condition and the folklore. The recent diagnosis comes from of a group of medical researchers who analyzed portraits of the Renaissance master from different points in his life. Most of the time the facial hairs are fine, so the hirsutism is barely noticeable. Porphyria is a group of rare diseases that affect the heme production in our blood. The treatment apparently cures the disease over a period of years. He was buried alive after an accident left him in a deep coma that doctors couldn't differentiate from death. Pharmaceutical-grade beta carotene may be used in its treatment. 14. Heme infusions help in the treatment of porphyria patients in two ways. In 1810, he suffered a total relapse, from which he was never to recover. 13. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. 11. All these symptoms resolve once the acute attack passes. [40] Intestinal pseudo-obstruction, ileus, intussusception, hypoganglionosis, and encopresis in children have been associated with porphyrias. Evidence that the famed Roman general and dictator suffered from ill health is found in the writings of several ancient historians. Other future treatments for porphyria will depend on the results obtained from research with experimental animal--and even plant--models. This is due usually to an inherited deficiency in an enzyme called ferrochelatase or heme synthase, the final enzyme in the heme synthetic pathway. Catherine Zeta-Jones. [41] Magnesium sulfate and bromides have also been used in porphyria seizures; however, development of status epilepticus in porphyria may not respond to magnesium alone. [2] They may be inherited in an autosomal dominant, autosomal recessive, or X-linked dominant manner. The King existed at Windsor Castle for the next ten years, neglected and unkempt, a blind and deaf octogenarian. The pain, burning, swelling, and itching that occur in erythropoietic porphyrias generally require avoidance of bright sunlight. Hello I am from Pakistan. "Porphyria's Lover" is a poem by the British poet Robert Browning, first published in 1836. Heme function plays a central role in cellular metabolism. Gaten Matarazzo Variegate porphyria is most common in South America with an incidence rate that is as high as 3 in every 1,000 people. Nikola Tesla was often mentally compromised, and Wolfgang Amadeus Mozart suffered from mood swings. However, oral contraceptives have also triggered photosensitivity and withdrawal of oral contraceptives has triggered attacks. [2][4] If the skin is affected, blisters or itching may occur with sunlight exposure. [2], Hormonal fluctuations that contribute to cyclical attacks in women have been treated with oral contraceptives and luteinizing hormones to shut down menstrual cycles. The principal problem in these deficiencies is the accumulation of porphyrins, the heme precursors, which are toxic to tissue in high concentrations. Porphyrias usually develop because of an inherited genetic mutation. The severity of the jam also varies. Clinical chemistry and Metabolic Medicine. Think about the schedule. Stokvis described the clinical syndrome as "porphyria," and from then on more and more forms of the syndrome were discovered. [16][30] In general, urine estimation of porphobilinogen (PBG) is the first step if acute porphyria is suspected. What was Robert Browning's most famous poem, and why? A 1995 article from the Postgraduate Medical Journal (via NIH) explains: As it was believed that the folkloric vampire could move about freely in daylight hours, as opposed to the 20th century variant, congenital erythropoietic porphyria cannot readily explain the folkloric vampire but may be an explanation of the vampire as we know it in the 20th century. The sum of Prince William's symptoms were typical of porphyria.. Dr Bellringer tentatively diagnosed porphyria, although he was aware of the theory of the royal family's history of porphyria then being put forward by Macalpine and Hunter, he stated he "tried not to let it influence himwith all the symptoms, I was left with little option but to diagnose the Prince's condition as porphyria." Mary's symptoms included gastric ulcers, rheumatism and hysteria. The abnormal porphyrins: deposit in skin, where they cause a terrible itchy rash on exposure to sunlight 15. William was later examined by haematologists at Addenbrookes hospital in Cambridge and also by Professor Ishihara in Tokyo, both of whom also concluded he was suffering from variegate porphyria, by then in remission. [1] Porphyrias may also be classified by whether the liver or bone marrow is affected. As a result of feedback, the decreased production of heme leads to increased production of precursors, PBG being one of the first substances in the porphyrin synthesis pathway. Instead, exposure to sunligh t can cause people with these types of porphyria to have skin symptoms such as: 2. mercury- or arsenic poisoning-induced porphyria, other changes in porphyrin profiles appear, most notably elevations of uroporphyrins I & III, coproporphyrins I & III, and pre-coproporphyrin. Some people may have porphyria, but have it be in remission until lifestyle circumstances change. Porphyria Cutanea Tarda occurs in the Cacausian population at a rate of 1 in 25,000. Following a variable period of, Vesiculo-erosive skin disease. Browse 239 porphyria stock photos and images available, or start a new search to explore more stock photos and images. People with cutaneous porphyria develop blisters, itching, and swelling of their skin when it is exposed to sunlight. Resolution. He often . Much speculation has been devoted to Jane Austens sickness in the years since, with the most common diagnosis being that she suffered from Addisons disease, a malfunction of the adrenal glands that wasnt known to medicine until several years after her death. Nausea can be severe; it may respond to phenothiazine drugs but is sometimes intractable. Most people that become paraplegics have sustained serious spinal cord injuries. Veterans who have been exposed to Agent Orange have been diagnosed with Porphyria may be diagnosed with up to a 10% disability because of this condition. Sometimes, however, the hair growth can give the appearance of a werewolf, leading to speculations that the myths may have had a medical basis. In the longer term, hope to cure porphyria is invested in gene therapy, in which the faulty genes are replaced with functional ones using a virus as a vector (delivery method). Caryn Elaine Johnson, professionally known as Whoopi Goldberg, is a famous author, comedian, actress, and talk show host. However, they . Some psychotropic drugs are porphyrinogenic, limiting the therapeutic scope. Plants make chlorophyll via a pathway very similar to that for heme production in animals. In 1889, Dr. B.J. Later, in the Byzantine Empire, the term porphyrogenitos, or "born to the purple," literally meant that the imperial heir was born after the fathers accession to the throne, in a palace room draped in the color. She also experienced bouts of abdominal pain, lameness, fits and episodes of mental disturbance since her teens. Androgens and fertility hormones have also triggered attacks. Famous British People. Only about 1 in 10,000 people have the most common form of porphyria (PCT), while 1 in 1 million people have CEP. It has been suggested that King George III of Great Britain suffered from the haem biosynthetic disorder, variegate porphyria. Skin disease is encountered where excess porphyrins accumulate in the skin. As such he also descended from King George III. Exposure to sunlight is the greatest issue. In 2015, I decided to go on a high protein low carb diet to get healthy. AHP is a hereditary disease, meaning that it . [31] In nearly all cases of acute porphyria syndromes, urinary PBG is markedly elevated except for the very rare ALA dehydratase deficiency or in patients with symptoms due to hereditary tyrosinemia type I. Fasting of 24 hours can promote symptom triggers, but intermittent fasting has also shown to be helpful in symptom reduction. 8. Two distinct patterns of skin disease are seen in porphyria: The porphyrias are generally considered genetic in nature. Population Estimate: Fewer than 1,000 people in the U.S. have this disease. This is not the main problem in the porphyrias; most heme synthesis enzymeseven dysfunctional enzymeshave enough residual activity to assist in heme biosynthesis. FACT CHECK: We strive for accuracy and fairness. Russell Brand. Vlad Had The Habsburg Lip. Some benzodiazepines are safe and, when used in conjunction with newer anti-seizure medications such as gabapentin, offer a possible regimen for seizure control. They exhumed his body days after he was buried, and the doctors found that he was alive. These include hemochromatosis and hepatitis C. Treatment of iron overload may be required. Mother Teresa (1910 - 1997) Macedonian Catholic missionary nun. This is typical of XLDPP and EPP. These drugs need to be given very early in an attack to be effective; effectiveness varies amongst individuals. It is the only commercially available treatment in the United States. - Quora The novel deals heavily with themes of gender and sexuality. Discover world-changing science. X-linked dominant protoporphyria is a rare form of erythropoietic protoporphyria caused by a gain-of-function mutation in ALAS2 characterized by severe photosensitivity. Just one year later, she was dead at the age of 41. His was most likely the first description of protoporphyria. What famous people have Porphyria? After 2 months when my mother cut my nails, there was some water. [2], The precise prevalence of porphyria is unclear, but it is estimated to affect between 1 and 100 per 50,000 people. These eight celebrities and famous historical figures have all lived with bipolar disorder. But they have a dark side: when the wrong forms of them build up in the body, they cause a disease called porphyria. Erythropoietic protoporphyria (EPP), the most common kind of porphyria to occur in childhood, causes people's skin to become very sensitive to light. George was often violent and talked incessantly and often obscenely for hours at a time. Some of these are improbable, to say the least. Nina Simone. One of the most common symptoms of people with acute porphyria is severe abdominal pain, which might also be accompanied by nausea, vomiting, constipation, and diarrhea. Alvin Ailey. . 2. 6 Acute porphyria, whether symptomatic or not, carries an increased risk of hypertension, hepatocellular carcinoma, and chronic renal failure. It could be a decision that makes life a whole lot easier. George eventually made a recovery and in the following twelve years suffered only slight attacks of his illness. . The Romans called the disease by various names including morbus caducus (the falling sickness), and it was widely believed at the time that its victims were touched by the gods. [28], Deficiency in the enzymes of the porphyrin pathway leads to insufficient production of heme. A recent Psychology study has posited that actors have a significantly higher rate of disordered personality traits. The most notorious environmental episode happened in Turkey in the 1950s, when 4,000 people developed a form of porphyria after eating wheat seeds that had been sprayed with a fungicide, hexachlorobenzene. Porphyria's Lover by Robert Browning. The theory formed the basis of a long-running play by Alan Bennett, The Madness of George III, which was later adapted for a film starring Nigel Hawthorne in the title role. Demi Lovato. The enzyme (hematin) necessary to alleviate symptoms is not absorbed intact on oral ingestion, and drinking blood would have no beneficial effect on the sufferer. Twice a week we compile our most fascinating features and deliver them straight to you. [citation needed], The underlying mechanism was first described by Felix Hoppe-Seyler in 1871,[52] and acute porphyrias were described by the Dutch physician Barend Stokvis in 1889.[53][54]. Tubman was known to go through spells and trance-like states, and one witness reported that she would drift off into a heavy sleep even when conversing, from which she will after a time arouse and resume the thread of her narrative where she left off. While her symptoms suggest she probably had narcolepsy, some have also suggested that she suffered from cataplexy, a condition that causes sudden muscle weakness and paralysis. Periodically drawing blood (phlebotomy) to reduce the iron in your body, which decreases porphyrins. The exact prevalence of porphyria is unknown, but it likely ranges from 1 in 500 to 1 in 50,000 people worldwide. 3. Daytime hours are generally best. Episodes of . Nearly all the patients who died had advanced porphyria and required mechanical ventilation. I love to write and share science related Stuff Here on my Website. Porphyria's Lover And My Last Duchess Comparison. Dreamstime is the world`s largest stock photography community. 2. 18th century author Samuel Johnson is renowned for penning witty essays and compiling one of the first comprehensive English-language dictionaries, but many medical researchers also consider him an early case study in Tourette syndrome. For instance, the polyneuropathy of acute porphyria may be mistaken for GuillainBarr syndrome, and porphyria testing is commonly recommended in those situations. [citation needed], As most porphyrias are rare conditions, general hospital labs typically do not have the expertise, technology, or staff time to perform porphyria testing. Throughout the 20th century Frida Kahlo was renowned for self portraits and masterpieces. The Greeks borrowed the term from the Phoenicians, who extracted a purple pigment from purpura mollusks to dye the garments of their royal family. [2] Rarely, a liver transplant may be carried out. www scuola test verifica sulle regioni del nord italia. Acute Intermittent Porphyria has been reported in the range of 1.5-10 per 100,000 but most carriers of a mutant allele never develop symptoms. People who are under extreme emotional or physical stress may also suffer from porphyria attacks. Most seizure medications exacerbate this condition. Surprisingly, even plants--which use the green porphyrin, chlorophyll, to absorb light energy--can suffer from a condition analogous to porphyria. It's thought Bram Stoker named Count Dracula after Vlad Dracul, also known as Vlad the Impaler. Public Domain George III ruled Britain for more than half a century and presided over the Seven Years' War and the American. Porphyria is a group of liver disorders in which substances called porphyrins build up in the body, negatively affecting the skin or nervous system. Historians long hypothesized that his madness may have been due to an undiagnosed family history of porphyria. But bone-marrow transplantation presents its own challenges, and is considered a last resort. Porphyria is an incurable genetic disease, the symptoms of which align perfectly with those ascribed to vampires. [2] Genetic testing may be done to determine the specific mutation. It's estimated that 1 out of 10,000 to 25,000 people has this condition. Vlad Dracul was born in Transylvania, Romania. Only a medical provider can diagnose this condition, so if any unusual symptoms appear and do not go away, schedule an appointment right away. What are the five methods of dispute resolution? [citation needed], Cimetidine has also been reported to be effective for acute porphyric crisis and possibly effective for long-term prophylaxis. If any of these eight steps fails because of an inherited genetic mutation or an environmental toxin, then the whole assembly line gets jammed. Download Porphyria stock photos. "They washed my little leg in a small tub with walnut water and small hot . It was further theorised that George inherited the disease from his five greats grandmother Mary, Queen of Scots, although this part of the theory is subject to debate. The woman responsible for leading hundreds of slaves to freedom on the Underground Railroad may have also suffered from a chronic sleep disorder. Recent medical tests performed on the remains of Charlotte and Feodora, who committed suicide at the age of 66 in 1945, have revealed that both probably suffered from porphyria.

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