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hormones, or within the external environment, such because the impact of certain medicine and as barbiturates in acute intermittent porphyria. This dysfunction is characterized by attacks of stomach pain, constipation, and psychiatric disturbances and is due to a mutation in a gene coding for an enzyme concerned in heme biosynthesis. Attacks can be precipitated by certain medication, including phenobarbital and the sulfonamides. Avoidance of those precipitating factors will result in nonpenetrance of the dysfunction. Environmental influences include dietary

 

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