The evaluation of acute intermittent porphyria begins with a medical history and physical examination.

The physical examination is usually normal.

Physical findings in those with acute intermittent porphyria may include:

• Abdominal tenderness
• Arm weakness (bilateral)
• Leg weakness (bilateral)
• Decreased deep tendon reflexes
• Rapid pulse
• High blood pressure
• Fever
• Seizures
• Confusion

Tests are required to make the diagnosis of acute intermittent porphyria.

Tests that may be used to evaluate acute intermittent porphyria include:

• Complete blood count
• Kidney profile
• Urinalysis
• Blood porphyrins
• Urine porphobilinogens
• Urine porphyrins
• Blood assays for enzymes involved in heme metabolism