title: Severe 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) intoxication: clinical and laboratory effects.
abstract: A variety of health effects have been attributed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), but little information is available on the course of a verified high-level TCDD intoxication. In this paper we describe two cases of heavy intoxication with TCDD and present a 2-year follow-up including clinical, biochemical, hematologic, endocrine, and immunologic parameters monitored in two women, 30 and 27 years of age, who suffered from chloracne due to TCDD intoxication of unknown origin. Patient 1, who had the highest TCDD level ever recorded in an individual (144,000 pg/g blood fat), developed severe generalized chloracne, whereas in the second patient, despite heavy intoxication (26,000 pg/g blood fat), only mild facial acne lesions occurred. Both patients initially experienced nonspecific gastrointestinal symptoms. In Patient 1 we observed a moderate elevation of blood lipids, leukocytosis, anemia, and secondary amenorrhoea. The laboratory parameters in Patient 2 were all normal. Despite the high TCDD levels, apart from chloracne, only few clinical and biochemical health effects were observed within the first 2 years after TCDD intoxication.
authors.affiliation: Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, University of Vienna Medical School, Vienna, Austria. alexandra.geusau@akh-wien.ac.at
authors.forename: A
authors.initials: A
authors.lastname: Geusau
authors.forename: K
authors.initials: K
authors.lastname: Abraham
authors.forename: K
authors.initials: K
authors.lastname: Geissler
authors.forename: M O
authors.initials: MO
authors.lastname: Sator
authors.forename: G
authors.initials: G
authors.lastname: Stingl
authors.forename: E
authors.initials: E
authors.lastname: Tschachler
mesh_terms: D017486:Acneiform Eruptions / Q000139:chemically induced* / Q000188:drug therapy; D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced; D001317:Austria; D019411:Clinical Laboratory Techniques; D003879:Dermatologic Agents / Q000627:therapeutic use; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood; D019358:Fat Substitutes / Q000627:therapeutic use; D005227:Fatty Acids / Q000627:therapeutic use; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D000072317:Polychlorinated Dibenzodioxins / Q000097:blood / Q000506:poisoning*; D012176:Retinoids / Q000627:therapeutic use; D013395:Sucrose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013783:Textile Industry
chemical_list: D003879:Dermatologic Agents; D004785:Environmental Pollutants; D019358:Fat Substitutes; D005227:Fatty Acids; D000072317:Polychlorinated Dibenzodioxins; D012176:Retinoids; D013395:Sucrose; C013692:sucrose polyester