All are true about congenital erythropoetic porphyria except –
**Core Concept**
Congenital erythropoietic porphyria (CEP) is a rare, autosomal recessive genetic disorder characterized by the accumulation of porphyrins due to a deficiency in the enzyme uroporphyrinogen III synthase (UROS). This enzyme is crucial for the conversion of uroporphyrinogen I to uroporphyrinogen III in the heme biosynthesis pathway.
**Why the Correct Answer is Right**
The accumulation of porphyrins leads to their excessive excretion in the urine, causing the urine to turn red or pink. The skin becomes sensitive to sunlight, leading to blistering and scarring. The condition is also associated with anemia, which is caused by the impaired production of heme in red blood cells.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because CEP is indeed a genetic disorder, but it is not caused by a deficiency in the enzyme porphobilinogen deaminase (PBGD), which is associated with acute intermittent porphyria (AIP).
**Option B:** This option is incorrect because the primary accumulation of porphyrins in CEP is not uroporphyrin I, but rather uroporphyrinogen I, which is the substrate of the deficient enzyme UROS.
**Option C:** This option is incorrect because while anemia is a feature of CEP, it is not the primary cause of the condition.
**Option D:** This option is incorrect because the skin manifestations of CEP are not limited to xerosis (dry skin), but also include blistering and scarring.
**Clinical Pearl / High-Yield Fact**
CEP is a classic example of a congenital disorder of porphyrin metabolism, and it is essential to remember that the accumulation of porphyrins in urine is a hallmark of this condition.
**Correct Answer: A. This option is incorrect because CEP is indeed a genetic disorder, but it is not caused by a deficiency in the enzyme porphobilinogen deaminase (PBGD), which is associated with acute intermittent porphyria (AIP).**