Late Hematologic Complications of Mustard Gas (original) (raw)
Related papers
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine, 2003
Approximately 34,000 Iranians known to have sustained mustard agent exposure during the Iran-Iraq war of 1980-1988 and survived over a decade afterwards were screened for distribution of the most commonly occurring medical problems. In order of greatest incidence, these include lesions of the lungs (42.5%), eyes (39.3%), and skin (24.5%). Within each subpopulation, patients were ranked according to severity of lesions. Twenty-three percent to 37% of patients exhibited at least mild coverage, with 1.5% to 4.5% classed as moderate, and a much smaller population (0.023-1.0%) of the 34,000 patients exhibiting extensive (severe) lesional coverage. These results provide a comprehensive overview of the medical problem most common among mustard victims and could serve as a predictor of the likely impact of these weapons on health status of populations exposed to them during ongoing military conflicts.
Toxicology Letters, 2019
Sulfur mustard (SM) is a vesicant chemical warfare agent. Recent studies reported alleged use of SM by non-state actors in Syria and Iraq. It has been shown that SM induced immunological and hematological complications. The aim of this study was to determine acute toxic effects of SM exposure on hematological parameters. Blood samples from a group of Syrian exposed to SM in 2016 were taken daily during the follow-up of the patients in intensive care unit. Initial leukocytosis was observed in all patients (100%) on the first 48 h after exposure. Following leukocytosis, isolated lymphopenia was observed in all patients (100%) between 2 nd and 4 th days. A decrease in hemoglobin level was noted in five patients (62.5%) between 4 th and 5 th days. Thrombocytopenia was observed in 75% of patients between 4 th and 6 th days for mild cases and between 9 th and 11 th days for severe cases. Three patients (37.5%) developed distinct leucopenia/neutropenia on 11 th and 12 th days. It was observed that human exposure to high dose of SM has direct toxic effect on hematological cells and bone marrow. New strategies on treatment of SM-induced myelosuppression could reduce the effects of hematological complications and could increase the survival rate in these patients.
Verification of Exposure to Sulfur Mustard in Two Casualties of the Iran-Iraq Conflict
Journal of Analytical Toxicology, 1997
The exposure of two Iranian victims of the iran-lraq conflict (1980-1988) to sulfur mustard was established by immunochemical and mass spectrometric analysis of blood samples taken 22 and 26 days after the alleged exposure. One victim suffered from skin injuries compatible with sulfur mustard intoxication but did not have lung injuries; the symptoms of the other victim were only vaguely compatible with sulfur mustard intoxication. Both patients recovered. Immunochemical analysis was based on detection of the N7-guanine adduct of the agent in DNA from lymphocytes and granulocytes, whereas the N-terminal valine adduct in globin was determined by gas chromatography-mass spectrometry after a modified Edman degradation. The valine adduct levels correspond with those found in human blood after in vitro treatment with 0.gpM sulfur mustard.
2014
Background & Objectives: Respiratory, central nervous system, and skin complications of mustard gas toxicity have previously been studied; however, the liver and kidney side effects due to this intoxication have not been fully noted. We aimed to evaluate the frequency of liver, kidney and lung lesions in mustard gas-exposed Iranian veterans who had been exposed to the toxin almost 2 decades before. Methods: A total of 100 veteran bodies underwent autopsy by at least two forensic medicine specialists. The liver, kidney and lung specimens were sent for pathological examination and their lesions, severity of the lesions, and the relation between the type/severity of the lesions and the time elapsed since their appearance were studied. Results: A total of 83%, 63%, and 62% of the veterans had lung, liver, and kidney pathologies. The most common pathologies included liver steatosis, interstitial fibrosis of the kidney, and lung atelectasis. Conclusion: Liver and kidney pathologies are far more common than what is considered in the mustard gas-exposed veterans. These pathologies are often accompanied by very severe lung complications.
Mustard gas toxicity: the acute and chronic pathological effects
Journal of Applied Toxicology, 2010
Ever since it was first used in armed conflict, mustard gas (sulfur mustard, MG) has been known to cause a wide range of acute and chronic injuries to exposure victims. The earliest descriptions of these injuries were published during and in the immediate aftermath of the First World War, and a further series of accounts followed the Second World War. More recently, MG has been deployed in warfare in the Middle East and this resulted in large numbers of victims, whose conditions have been studied in detail at hospitals in the region. In this review, we bring together the older and more recent clinical studies on MG toxicity and summarize what is now known about the acute and chronic effects of the agent on the eyes, skin, respiratory tract and other physiological systems. In the majority of patients, the most clinically serious long-term consequences of MG poisoning are on the respiratory system, but the effects on the skin and other systems also have a significant impact on quality of life. Aspects of the management of these patients are discussed.
Toxin Reviews, 2009
Sulfur mustard (SM) is a vesicant or blistering chemical agent that possesses mutagenic and carcinogenic properties and alkylates DNA. Little is known about the long-term effects of sulfur mustard on blood cells. The aim of this study is to examine the long-term effects of SM on peripheral blood cells in SM victims of the Iraq-Iran war (1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988). This study, which is a part of Sardasht Iran Cohort Study (SICS) was designed in two groups: exposed (372 participants from Sardasht) and control (128 unexposed people from Rabat). The exposed group was divided into hospitalized and not hospitalized subgroups based on the severity of lesions at exposure time. A comparison was made between the study groups' overall blood exams. The hospitalized group had significantly higher numbers of red blood cells (p = 0.003) than not hospitalized and the control groups. The exposed group had significantly higher HCT and MCV (P = 0.007) than the control group. Exposure group had significantly lower numbers of PLT (P = 0.001), WBC (P = 0.006) and PMN (P = 0.001) than the control group but from clinical viewpoint this difference is not valuable. Further, lymph cells (P = 0.001) in the exposed group were significantly higher than in the control group. Our research findings suggested the probability of severe damage to bone marrow and predisposing to infection in other organs (especially lung) due to exposure to SM in the exposed group.