Clinical and analytical findings in patients affected with the toxic oil syndrome. Study of a cohort of 758 patients

Objective. To report the symptoms and analytical findings observed in the c ollective of patients affected with the toxic oil syndrome (TOS) 18 years a fter the poisoning. Methods. At the Centro de Investigacion sobre el Sindrome del Aceite Toxico (CISAT) we followed the clinical and analytical course of 758 patients aff ected with the TOS since December 1997 up to May 1999. patients were evalua ted by means of a previously standardized questionnaire in which a clinical review and a battery of complementary tests (thyroid hormones, spirometry with diffusion test and arterial gasometry) were included. One hundred and sixty-two patients underwent also echocardiogram because of presumptive pul monary hypertension and/or heart disease. Results. Out of the 758 patients, 516 were females and 242 males (M:F ratio 2:1), with ages ranging from 17 to 84 years (mean age 47 years). One of th e most remarkable findings was the increased prevalence of cardiovascular r isk factors: arterial hypertension (34%), dyslipemias (44%), overweight (40 %), obesity (27%), carbohydrate intolerance (9%) and diabetes mellitus (9.4 %). The most common reported symptoms were: cramps (78%), arthralgias (78%) , and paresthesias (70%). Only 2.8% of patients reported to be asymptomatic . The analytical results most commonly changed were: changes in lipidic and carbohydrate metabolism (already reported), overt or subclinical hypothyro idism (6.6%) and respiratory changes in patients with no previous pulmonary disease: changes in spirometry (6%), diffusion test (8%) and hypoxemia (18 %). Echocardiographic findings suggestive of PHT were obtained in 3.1% of c ases. Conclusions. Although TOS occurred in 1981, this syndrome still has a relev ant morbidity in a portion of the spanish population. To remark the high pr evalence of cardiovascular risk factors with changes in lipidic and carbohy drate metabolism and subclinical hypothyroidism observed in our series. Fur ther studies are necessary to evaluate the actual dimension of this poisoni ng.