Between 1965 and 1968, about 350 workers were accidentally exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in a chemical plant, which was producing herbicides based on the trichlorophenoxyacetic acid. About 80 workers developed signs of poisoning. The estimated mean concentration of TCDD at the time of exposure was about 5000 pg/g of plasma fat. Only 15 subjects from the original cohort remained available for the recent follow-up in 2004. All were men, mean age 60 years. The mean current TCDD plasma concentration was 128 pg/g. Neurological examination revealed some CNS impairment in eight subjects. Signs of polyneuropathy were found in nine subjects, confirmed by NCV studies in three cases. Electroencephalography was abnormal in three cases; Visual-evoked potential in five cases. Acquired dyschromatopsia was detected in six patients. SPECT showed focal reduction of perfusion in various brain locations in all but one patient. Two neuropsychological variables and the frequency of abnormal neurophysiological tests in individual patients correlated with TCDD plasma level. The findings support the hypothesis that TCDD can damage the nervous system. In addition to a direct neurotoxic effect of TCDD, changes secondary to vasculopathy should be considered, in the pathophysiology of the damage, because of the high frequency of lipid metabolism disorders and their complications.
- MeSH
- cerebrovaskulární poruchy MeSH
- chronická nemoc MeSH
- elektroencefalografie MeSH
- financování organizované MeSH
- jednofotonová emisní výpočetní tomografie MeSH
- látky znečišťující životní prostředí krev otrava MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- nemoci centrálního nervového systému diagnóza chemicky indukované MeSH
- nemoci nervového systému diagnóza chemicky indukované MeSH
- nemoci z povolání diagnóza patofyziologie psychologie MeSH
- nervové vedení MeSH
- neurologické vyšetření MeSH
- neuropsychologické testy MeSH
- polychlorované dibenzodioxiny krev otrava MeSH
- polyneuropatie diagnóza chemicky indukované patofyziologie MeSH
- poruchy barevného vidění diagnóza chemicky indukované MeSH
- zrakové evokované potenciály účinky léků MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
Past reports have correlated a diagnosis of porphyria cutanea tarda (PCT) with exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Re-examination of the literature, however, has caused us to question the conclusion of a relationship between acquired PCT and TCDD. The major considerations at issue were: (1) whether the diagnostic label of PCT was applied excessively to cases with findings that are nonspecific; (2) whether the clinical conditions suggestive of PCT were the likely results of exposure to another chemical, for example hexachlorobenzene (HCB); and (3) whether a causal link between PCT and TCDD is reasonably substantiated by the facts. Based on the re-evaluation of the literature, the known effects of HCB and TCDD, and the follow-up results from the chemical plant, we submit that HCB alone, or HCB in combination with other polychlorinated aromatic hydrocarbons, may have been responsible for the effects observed and the subsequent correlation to PCT.
- MeSH
- dioxiny otrava MeSH
- dospělí MeSH
- kožní nemoci chemicky indukované epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci z povolání chemicky indukované epidemiologie MeSH
- polychlorované dibenzodioxiny otrava MeSH
- porfyrie chemicky indukované epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
- Geografické názvy
- Československo MeSH
- New Jersey MeSH
