Acute intermittent porphyria, porphyria variegata, and to a lesser degree hereditary coproporphyria can cause acute symptoms: abdominal pains and general symptoms. The symptoms begin after puberty, most often between the ages of 20 and 40 years. Symptoms may be triggered by certain drugs (barbiturates, sulphonamides, oestrogen, chloroquine; a complete list of unsafe and safe drugs can be seen at www.porphyria-europe.com ) alcohol, menstruation, infection, or fasting. All precipitating factors should be eliminated during acute symptoms. Porphyrias are inherited dominantly and autosomally. When a new case is found, family members should be examined to find symptomless patients.Acute porphyrias are associated with a significantly increased risk of liver cancer . If a porphyria patient over 50–60 years of age has persistent upper abdominal pains or debilitation of the general condition, the possibility of liver cancer should be taken into account.