Matsumoto Y, Kawabe M, Yasue T, Yuguchi M, Yoshida I
Nihon Hifuka Gakkai Zasshi. 1989 Feb;99(2):155-61.
Case 1, a 49-year-old male who had been engaged in repair and reclamation of automobile tires, developed symptoms of vibration syndrome (Raynaud's phenomenon, numbness of both hands, tinnitus and impaired hearing) after some 30 years' use of a grinder and impact wrench. Two years thereafter, multiple sclerodermic lesions appeared over the trunk, upper extremities, and thighs; these disappeared about 2 years later. Histologically, hyperplasia and nodular swelling of collagen bundles were present in the dermis. An immunological study showed the serum to be positive for anti-centromere antibody, but no visceral lesions were demonstrable. This case corresponded to generalized morphea. Case 2, a 53-year-old male, developed symptoms of vibration syndrome (Raynaud's phenomenon, numbness of both hands, impaired hearing and arthralgia) after 25 years' use of a jack hammer in a quarry. Thereafter, sclerodermic changes of the forearms, lower legs, face and abdomen occurred with an associated sclerodactyly. Histological examination of involved skin revealed diffuse hyperplasia and homogenization of collagen bundles throughout the entire thickness of the dermis. These findings, together with serum positivity for anti-RNP antibody and dilation of the lower portion of the esophagus, led us to a diagnosis of progressive systemic sclerosis. We inferred that the vibration syndrome in the present cases might be related etiologically to these forms of scleroderma.
病例1，一名49岁男性，从事汽车轮胎修补和翻新工作，在使用砂轮机和冲击扳手约30年后出现振动综合征症状（雷诺现象、双手麻木、耳鸣和听力受损）。两年后，躯干、上肢和大腿出现多发性硬皮病样损害；约2年后这些损害消失。组织学检查显示真皮层胶原束增生和结节状肿胀。免疫学研究表明血清抗着丝点抗体呈阳性，但未发现内脏损害。该病例符合泛发性硬斑病。病例2，一名53岁男性，在采石场使用风镐25年后出现振动综合征症状（雷诺现象、双手麻木、听力受损和关节痛）。此后，前臂、小腿、面部和腹部出现硬皮病样改变，并伴有指（趾）硬皮病。对受累皮肤的组织学检查显示真皮全层胶原束弥漫性增生和均质化。这些发现，连同血清抗核糖核蛋白抗体阳性和食管下段扩张，使我们诊断为进行性系统性硬化症。我们推断，本病例中的振动综合征可能在病因上与这些硬皮病形式有关。
