Abstract
Acute porphyria is a group of metabolic disorders characterized by a deficiency in enzymes involved in heme biosynthesis. A 21-year-old female with abdominal pain and an altered sensorium, eventually leading to a diagnosis of acute porphyria. Glucose treatment and other supportive measures were given and her general condition improved. Renal biopsy was done in view of persistent renal dysfunction, which revealed acute tubulointerstitial nephritis with 5-10% interstitial fibrosis and tubular atrophy. This Case highlights a unique manifestation of acute porphyria involving the kidney and emphasizes the importance of considering acute tubulointerstitial nephritis as a cause of renal dysfunction in acute porphyria.