Korényi-Both A L, Korényi-Both A L, Juncer D J
Office of the State Surgeon, Pennsylvania National Guard, Department of Military and Veteran's Affairs, Commonwealth of Pennsylvania 17003-5003, USA.
Mil Med. 1997 Jan;162(1):1-13.
This article examines the potential relationship between Al Eskan disease and the Persian Gulf syndrome. Al Eskan disease, reported in Military Medicine in 1992, is a novel and previously unreported condition triggered by the exceptionally fine sand dust of the Central and Eastern Saudi Arabian peninsula. We repeat our study of the pathogenesis of Al Eskan disease to include the ultrastructural and microanalytical study of the sand, aerobiological studies of the Kingdom of Saudi Arabia, and the etiology, symptoms, and prevalence of the disease. We conclude that immunodepression resulting from the continued presence of sand particles less than 1 micron in diameter in the lungs and bodies of Persian Gulf veterans explains not only the symptoms of the hyperegic lung condition of phase I and the symptoms of phase II of Al Eskan disease, but also provides an important clue to a common factor in most cases of Persian Gulf illnesses. We include a discussion of most of the commonly suspected agents in the Persian Gulf syndrome. In this case, we conclude that each of these factors, such as oil well fires, old-world diseases, or depleted uranium, are probably adjuvant or contributing causes. The only common exposure that would lead to recognition of the Persian Gulf syndrome as a single medical condition, rather than a catch-all phrase for unrelated conditions, appears to be exposure to the ubiquitous, fine sand of the area, and a resulting immunosuppression that is aggravated by opportunistic infections and other nonmicrobial ailments.
本文探讨了艾尔埃斯坎病与海湾战争综合征之间的潜在关系。1992年在《军事医学》上报道的艾尔埃斯坎病，是一种由沙特阿拉伯半岛中部和东部异常细小的沙尘引发的新型且此前未报道过的病症。我们重复了对艾尔埃斯坎病发病机制的研究，包括对沙子的超微结构和微量分析研究、沙特阿拉伯王国的空气生物学研究，以及该疾病的病因、症状和患病率。我们得出结论，海湾战争退伍军人肺部和体内持续存在直径小于1微米的沙粒导致的免疫抑制，不仅解释了第一阶段过敏性肺部疾病的症状和艾尔埃斯坎病第二阶段的症状，还为大多数海湾战争疾病病例中的一个共同因素提供了重要线索。我们讨论了海湾战争综合征中最常被怀疑的因素。在这种情况下，我们得出结论，这些因素中的每一个，如油井大火、旧世界疾病或贫铀，可能都是辅助性或促成性原因。唯一能使海湾战争综合征被确认为一种单一病症，而非用于无关病症的统称的常见暴露因素，似乎是接触该地区无处不在的细沙，以及由此导致的免疫抑制，这种免疫抑制会因机会性感染和其他非微生物疾病而加重。
