Huang Yong-Shun, Huang Han-Lin, Wu Qi-Feng, Xia Li-Hua, Huang Ming, Qiu Xin-Xiang, Zhou Shan-Yu
Department of Occupational Medicine, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong 510300, P.R. China.
Department of Occupational Medicine, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong 510300, P.R. China; Department of Scientific Education, Guangdong Women and Children Hospital, Guangzhou, Guangdong 511442, P.R. China.
Exp Ther Med. 2016 Aug;12(2):895-900. doi: 10.3892/etm.2016.3357. Epub 2016 May 18.
The present study aimed to explore the stability, curability and sequelae of cases of Trichloroethylene (TCE) Hypersensitivity Syndrome (THS), and to investigate the causal allergens of THS. Two cases of THS were followed-up in the current study; both cases were healing following glucocorticoid therapy and were discharged >10 weeks prior to follow-up. A questionnaire investigation, health examination and patch test were performed. Allergens of TCE and its metabolites, including chloral hydrate, trichloroethanol (TCOH) and trichloroacetic acid, were applied in the patch test; 4 controls were included. The two subjects were experiencing itching, pigmentation and xerosis of the skin, and had abnormal results in the ophthalmology Schirmer I test and tear break-up time. The body temperature, liver function, superficial lymph nodes, blood, urine routine and autoimmune antibodies of two subjects were shown to be normal, and no new rashes had appeared. All mass concentration of chloral hydrate and TCOH were positive; 5.0% trichloroacetic acid was weakly positive, 0.5% trichloroacetic acid and all mass concentration of TCE were negative. All patch tests were negative in the 4 control subjects. The results suggest that THS was stable following treatment with glucocorticoid therapy. Dry eye syndrome may continue as a sequelae of THS. The patch test demonstrated that the mechanism underlying THS is delayed-type hypersensitivity induced by TCE. In addition, as the hypersensitivity state in a THS rehabilitee could be sustained over a long period of time, it suggests that the metabolites of TCE, not TCE itself, are responsible for THS. Therefore, patients with THS should avoid contact with TCE and its metabolites, and avoid using hypnotic and anticonvulsive drugs containing chloral hydra as the primary ingredient.
本研究旨在探讨三氯乙烯（TCE）超敏综合征（THS）病例的稳定性、可治愈性及后遗症，并调查THS的致敏原。本研究对2例THS患者进行了随访；2例患者经糖皮质激素治疗后均已痊愈，且在随访前10周以上出院。进行了问卷调查、健康检查及斑贴试验。斑贴试验中使用了TCE及其代谢产物的变应原，包括水合氯醛、三氯乙醇（TCOH）和三氯乙酸；纳入了4名对照者。2名受试者存在皮肤瘙痒、色素沉着及干燥，且眼科Schirmer I试验及泪膜破裂时间结果异常。2名受试者的体温、肝功能、浅表淋巴结、血液、尿常规及自身抗体均正常，且未出现新的皮疹。水合氯醛和TCOH的所有质量浓度均为阳性；5.0%三氯乙酸弱阳性，0.5%三氯乙酸及TCE的所有质量浓度均为阴性。4名对照者的所有斑贴试验均为阴性。结果表明，糖皮质激素治疗后THS病情稳定。干眼症可能作为THS的后遗症持续存在。斑贴试验表明，THS的发病机制是由TCE诱发的迟发型超敏反应。此外，由于THS康复者的超敏状态可长期持续，这表明是TCE的代谢产物而非TCE本身导致了THS。因此，THS患者应避免接触TCE及其代谢产物，避免使用以水合氯醛为主要成分的催眠及抗惊厥药物。
