Phelps R G, Fleischmajer R
Department of Dermatology, Mount Sinai Medical Center, New York, NY 10029.
J Am Acad Dermatol. 1988 Feb;18(2 Pt 1):313-24. doi: 10.1016/s0190-9622(88)70046-8.
The clinical, pathologic, and immunopathologic findings of 14 patients with the toxic oil syndrome are presented. The toxic oil syndrome occurred in Madrid, Spain, as a consequence of ingestion of an industrial oil sold as olive oil. The syndrome occurred in two phases. In the acute phase patients developed an interstitial pneumonitis, fever, and exanthem, and some died of respiratory insufficiency. Of those who survived, some developed a chronic phase with a neuromyopathic and scleroderma-like illness that had many features of a collagen vascular disease. Histologic examination of lung in the acute phase showed an endovasculitis and features of adult respiratory distress syndrome. In the chronic phase the skin showed various degrees of sclerodermoid changes and vessel injury. Immunofluorescence with antiprocollagen and antifibronectin antibodies revealed abundant perivascular fluorescence suggestive of vascular injury. Electron microscopy corroborated this by the presence of endothelial swelling and basal lamina reduplication. Similar findings have been described in systemic sclerosis, and this provides an important model for study of connective tissue disease, including scleroderma.
本文报告了14例有毒油综合征患者的临床、病理及免疫病理表现。有毒油综合征发生于西班牙马德里，是因食用了作为橄榄油出售的工业用油所致。该综合征分为两个阶段。急性期患者出现间质性肺炎、发热和皮疹，部分患者死于呼吸功能不全。存活者中，部分进入慢性期，出现神经肌肉病和硬皮病样疾病，具有许多胶原血管病的特征。急性期肺组织学检查显示血管内皮炎及成人呼吸窘迫综合征的特征。慢性期皮肤出现不同程度的硬皮样改变和血管损伤。用抗前胶原和抗纤连蛋白抗体进行免疫荧光检查显示血管周围有丰富荧光，提示血管损伤。电子显微镜检查发现内皮细胞肿胀和基底膜重复，证实了这一点。系统性硬化症也有类似表现，这为研究包括硬皮病在内的结缔组织疾病提供了一个重要模型。
