Unmasking the "Little Imitator": Identifying and Managing Acute Hepatic Porphyria in the OB/GYN Setting

Released On
November 15, 2021

Expires On
November 15, 2022

Media Type

Completion Time
90 minutes

Obstetrics & Gynecology, Primary Care


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This activity is jointly provided by Catalyst Medical Education and Advancing Knowledge in Healthcare.

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

Credit Available

  • Physicians — maximum of 1.5 AMA PRA Category 1 Credit(s)
  • Nurses — 1.5 Contact Hours
  • Physician Assistants - 1.5 AAPA Category 1 CME credits

All other health care professionals completing this course will be issued a statement of participation.

Target Audience

This initiative is intended for obstetrics/gynecologic (OB/GYN) physicians, nurses, physician assistants and other healthcare professionals assessing patients in the OB/GYN setting.

Program Overview

Many women experience abdominal and pelvic pain related to their menstrual cycle or endometriosis. Yet for some women, these symptoms are due to a group of inherited diseases known as acute hepatic porphyria (AHP). On average, patients spend 15 years misdiagnosed and undergoing numerous medical tests and visits with specialists. This activity will explore how to differentially diagnose patients with unexplained pelvic pain, strategies for confirming a suspected diagnosis of AHP, and available treatments options to ensure early diagnosis and optimal outcomes.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Explain the etiology and pathophysiology of AHP as a cause of severe abdominal/pelvic pain among women 
  • Identify signs and symptoms suggestive of AHP that may present in women seeking OB/GYN care 
  • Define appropriate strategies to screen and diagnose AHP among OB/GYN patients 
  • Recognize the impact that the menstrual cycle- and medication-induced hormonal changes have on AHP attacks 
  • Assess the clinical utility of disease-specific therapies for preventing AHP attacks in women
  • Propose interdisciplinary strategies to individualize clinical management of AHP in the OB/GYN setting 



Karl E. Anderson, MD, FACP

Professor, Departments of Internal Medicine (Division of Gastroenterology and Hepatology) and Preventive Medicine and Population Health
Director, Clinical Science Graduate Program
Director, Porphyria Laboratory and Center
Member, Institute for Translational Sciences
University of Texas Medical Branch/UTMB Health
Galveston, TX


D. Montgomery Bissell, MD

Professor of Medicine, Emeritus
Department of Medicine
Director Emeritus, UCSF Liver Center 
San Francisco, CA


Herbert Lloyd Bonkovsky, MD

Professor of Medicine and Molecular Medicine and Translational Research and Director of the Liver and Metabolic Disorders Laboratory
Wake Forest University School of Medicine
Winston Salem, NC


Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and Catalyst Medical Education, LLC. AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation

Credit provided by AKH Inc., Advancing Knowledge in Healthcare.


AKH Inc., Advancing Knowledge in Healthcare designates this enduring material activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.5 AAPA Category 1 CME credits. Approval is valid until November 15, 2022. PAs should only claim credit commensurate with the extent of their participation.



1.5 ANCC contact hours

Disclosures of Conflicts of Interest

It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.

Karl E. Anderson, MD, FACP (Chairperson)
  • Consultant and Researcher: Alnylam Pharmaceuticals Mitsubishi Tanabe Pharma USA, Recordati Rare Diseases

D. Montgomery Bissell, MD, has no financial relationships to disclose.

Herbert Lloyd Bonkovsky, MD
  • Consultant : Disc Medicine, Protagonist Therapeutics, Recordati Rare Chemicals
  • Researcher (Awarded to Wake Forest) : Alnylam Pharma, Mitsubishi-Tanabe

Stephanie S. Wenick, MPhil, Medical Writer, has no financial relationships to disclose.
Dorothy Caputo, MA, BSN, RN, AKH CE Director of Accreditations, has disclosed no financial relationships.
Michele Bielarski, RN, Nurse Reviewer, has disclosed no financial relationships.
Trish Brignoni, AKH Director of Operations, has disclosed no financial relationships.
AKH and Catalyst Medical Education, LLC Planners and Reviewers, have disclosed no financial relationships.
All of the relevant financial relationships listed for these individuals have been mitigated.

Instructions for Participation and Credit

To obtain a certificate of completion, a score of 70% or better on the post-test is required. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your certificate. You must participate in the entire activity to receive credit. There is no fee to participate in this activity.

Course Viewing Requirements

Supported Browsers:
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above

Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above

Disclosure of Unlabeled Use

This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.

Contact Information

If you have questions about this activity, please contact AKH Inc. at tbrignoni@akhcme.com