Martinez-Tello F J, Tellez I
Hospital Universitario 12 de Octubre, Departamento de Anatomia Patologica, Madrid, Spain.
J Am Coll Cardiol. 1991 Oct;18(4):1043-7. doi: 10.1016/0735-1097(91)90764-z.
The toxic oil syndrome is a multisystemic disease caused by the ingestion of adulterated rapeseed oil. The basic lesion is a peculiar vasculitis that affects mainly the intima, showing the features of an endovasculitis. Vessels of every type and size are involved, affecting practically every organ. The vascular lesions begins with endothelial damage that varies from cellular swelling to cellular necrosis. It then progresses by mixed cellular inflammatory infiltration of the intima and, in some cases, of the media and adventitia. In some cases the infiltrate is rich in eosinophils and a few show foamy histiocytes. Proliferation of myointimal cells and in advanced stages fibroblastic proliferation causes narrowing or obliteration of the vascular lumen. Thromboembolic complications perpetuate the vascular lesion and compound the ischemia and parenchymal atrophy of several organs. The peripheral nerve lesions begin with an inflammatory neuropathy with lymphocytic perineuritis and progress to perineural fibrosis with secondary axonal degeneration. Skeletal muscle lesions exhibit an interstitial inflammatory myopathy at first, followed by a neurogenic muscular atrophy. A direct effect of unidentified toxic substances, possibly free radicals, may cause the endothelial lesion. Other factors, such as immunopathologic mechanisms of delayed hypersensitivity, may contribute to the progression of the vascular lesions.
中毒性油综合征是一种因摄入掺假菜籽油引起的多系统疾病。基本病变是一种特殊的血管炎，主要累及内膜，表现为血管内皮炎的特征。各种类型和大小的血管均受累，几乎影响到每个器官。血管病变始于内皮损伤，表现从细胞肿胀到细胞坏死不等。随后内膜出现混合性细胞炎性浸润，在某些情况下中膜和外膜也会出现。在某些病例中，浸润富含嗜酸性粒细胞，少数可见泡沫状组织细胞。肌内膜细胞增殖以及晚期的成纤维细胞增殖导致血管腔狭窄或闭塞。血栓栓塞并发症使血管病变持续存在，并加重多个器官的缺血和实质萎缩。周围神经病变始于伴有淋巴细胞性神经炎的炎性神经病，进而发展为伴有继发性轴索变性的神经周围纤维化。骨骼肌病变起初表现为间质性炎性肌病，随后发展为神经源性肌肉萎缩。不明毒性物质（可能是自由基）的直接作用可能导致内皮病变。其他因素，如迟发型超敏反应的免疫病理机制，可能促使血管病变进展。
