title: Aplastic anemia in a professional musician exposed to instrument polish.
abstract: Chemicals are known to cause toxin-induced aplastic anemia. However, some chemicals documented in only a few cases to possess only a possibility of toxic potential may also be responsible for the development of aplastic anemia. This report presents a case of a string musician with bone marrow failure. The patient used a certain type of polish (komalak) to shine his musical instrument and did this frequently. He presented with nasal bleeding, and a workup on admission revealed pancytopenia. Aplastic anemia was diagnosed on the basis of bone marrow histology results. An analysis for gene polymorphism related to the metabolic detoxification enzymes glutathione S-transferase and N-acetyltransferase 2 indicated that the patient was genetically susceptible to developing toxicity. This case suggests that frequent use of this polish may cause a toxic effect that leads to bone marrow failure. Musicians should be made aware of the risks associated with these types of chemicals.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Adana, Turkey. drcanboga@hotmail.com
authors.forename: Can
authors.initials: C
authors.lastname: Boga
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozdogu
authors.forename: Lulufer
authors.initials: L
authors.lastname: Tamer
authors.forename: Ebru
authors.initials: E
authors.lastname: Kizilkilic
authors.forename: Ilhan
authors.initials: I
authors.lastname: Tuncer
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000139:chemically induced*; D001191:Arylamine N-Acetyltransferase / Q000235:genetics; D005982:Glutathione Transferase / Q000235:genetics; D006801:Humans; D007219:Industrial Oils / Q000009:adverse effects*; D008297:Male; D009146:Music; D016273:Occupational Exposure; D011110:Polymorphism, Genetic
chemical_list: D001191:Arylamine N-Acetyltransferase; C478900:NAT2 protein, human; D005982:Glutathione Transferase