Case study,

A few days after a laparotomy for "intestinal obstruction," a young nurse from South Africa became emotionally disturbed and appeared to be hysterical. For more than 1 week before the surgery, she had taken barbiturate capsules as a sleep aid. She complained of severe abdominal and muscle pain and general weakness. Her tendon reflexes were absent, and she was vomiting and constipated. Her urine was dark in color on standing and gave a brilliant pink fluorescence when viewed in ultraviolet light. Within 24 hours, she was completely paralyzed, and after 2 days she expired.

Questions

1. What possible condition did this young woman have, and why did it manifest at this time?
2. Would members of her family be at risk for a similar disease?
3. Which enzyme defect should be suspected?

4. What other confirmatory tests, if any, could be performed?