CPOX and variegate porphyria: Acute hepatic porphyria (AHP) is a group of four distinct metabolic diseases caused by genetic defects in the heme synthesis pathway [1]: The most common subtype, Acute Intermittent Porphyria (AIP), is caused by a variant in the HMBS gene, followed by Variegate Porphyria (VP), resulting from a PPOX gene variant and Hereditary Coproporphyria (HCP), which is caused by a variant in the CPOX gene.