A 21-year-old healthy male college student went to celebrate his birthday with
some friends at a bar. His friends convinced him to have his first beer since he
just turned 21. After consuming the beer, he began to experience intense, wors-
ening abdominal pain that was nonspecific in location and described as cramp-
ing. Nausea and vomiting then ensued and he was taken to the ER. Upon
arrival to the ER, he was found to be very anxious with hallucinations. He was
noted to be hypertensive, tachycardic, and diaphoretic. Peripheral neuropathy
was also noticed on examination. Initial laboratory test revealed a normal
CBC, drug screen, and EtOH level. Serum and urine aminolevulinic acid
(ALA) and prophobilinogen (PBG) were both found to be elevated.
What is the likely diagnosis?
What is the underlying biochemical problem?