Small volume plasmapheresis in the management of porphyria cutanea tarda.

A 49-year-old man with porphyria cutanea tarda was treated with repeated small volume plasmapheresis. After the circadian change of urinary porphyrins was found to be higher between midnight and noon, approximately 250 mL of plasma was removed at 8 AM and was replaced by physiological saline. Clinical disease manifestations and abnormal laboratory findings rapidly improved following a total of 20 plasmapheresis during a 24-week period. The blood hemoglobin and plasma total protein levels were unchanged.