Boga Can, Ozdogu Hakan, Tamer Lulufer, Kizilkilic Ebru, Tuncer Ilhan
Division of Hematology, Department of Internal Medicine, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Adana, Turkey.
Int J Hematol. 2005 May;81(4):304-6. doi: 10.1532/IJH97.E0420.
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.
