Olfactory disorders and general pathologies. Analysis and literature review.

Introduction. - Disturbances of the sense of smell have been documented in many general pathologies. The actual etiology of such impairments is often difficult to determine. The aim of the authors is to review the literature on olfactory disorders in general diseases. Current knowledge and key points. - Acute and chronic liver disorders are f requently associated with hyposmia, which can be improved by vitamin A inta ke. Renal insufficiency could induce hyposmia according to the severity of the renal disease. Olfactory disorders seem to regress after transplantatio n but not after dialysis. Patients with AIDS - especially neurological form s - often present with taste and smell impairments. Smell alteration can al so be noted in hypothyroidism and pseudo-hypoparathyroidism. In addition, t aste and smell impairments have been described in patients with adrenal ins ufficiency or Gushing's disease. Subsequent to glucocorticoid therapy adren al insufficiency can induce regressive olfactory hypersensitivity. Olfactor y impairments in diabetic patients can be associated with diabetic macrovas cular manifestations due to ischemic alterations in the olfactory neuroepit helium. Impairment of the sense of smell has been described in many systemi c diseases such as Horton's arteritis and Sjogren's syndrome. Future prospects and projects. - Olfactory disorders should be investigated in patients presenting one of the above-mentioned diseases. (C) 2000 Editi ons medicales et scientifiques Elsevier SAS.