Toxic oil syndrome T65.3

Tabuenca 1981

Disease caused by poisoned edible oil with a phase-like course and great clinical similarity to chronic autoimmune diseases of the vascular connective tissue.

Epidemic 1981 in Spain.

Consumption of rapeseed oil denatured with aniline.

Acute phase: Women and men are affected equally often.

Chronic phase: Women are affected 6 to 10 times more often than men.

Acute phase: 7-10 days after consumption fever, dyspnea due to interstitial pneumonia and pulmonary edema, gastrointestinal complaints.

Subacute phase: After about 2 months, nonspecific pruriginous skin lesions, maculopapular or urticarial erythema, arthralgias, myalgias.

Chronic phase: From the 4th month, in 10-15% of patients neuromuscular syndrome with scleroderma-like or poikiloderma-like skin manifestations. Furthermore, livedo reticularis, Raynaud's syndrome, Sjögren's syndrome, carpal tunnel syndrome, dysphagia or pulmonary hypertension may occur.

eosinophilia (>1000 plates/mm3). IgE elevation. In 35-80% of cases ANA is positive.

Eosinophilic myalgia syndrome; pseudoscleroderma.

Symptomatic physical and external therapy (see also scleroderma, progressive systemic), causal therapy unknown. If only sclerotic skin changes are present (without systemic involvement), phototherapy with UVA1 (20 ^J/cm2, for 6-8 weeks, 4 times/week) or PUVA bath therapy.

In case of systemic involvement, proceed as in progressive systemic scleroderma.

Chronic stage: Progression over years. In the acute stage death by pulmonary complications.

1. Bell S et al (1992) The toxic oil syndrome - an example of an exogenously induced autoimmune disease. dermatologist 43: 339-343
2. Sanchez-Porro Valades P et al (2003) Toxic oil syndrome: survival in the whole cohort between 1981 and 1995 J Clin Epidemiol 56: 701-708
3. Hubbard V et al (2003) Scleromyxoedema-like changes in four renal dialysis patients. Br J Dermatol 148: 563-568