Severe 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) intoxication: Clinical and laboratory effects

A variety of health effects have been attributed to 2,3,7,8-tetrachlorodibe nzo-p-dioxin (TCDD), but little information is available on the course of a verified high-level TCDD intoxication. In this paper we describe two cases of heavy intoxication with TCDD and present a 2-year follow-up including c linical, biochemical, hematologic, endocrine, and immunologic parameters mo nitored in two women, 30 and 27 years of age, who suffered from chloracne d ue to TCDD intoxication of unknown origin. Patient 1, who had the highest T CDD level ever recorded in an individual (144,000 pg/g blood fat), develope d severe generalized chloracne, whereas in the second patient, despite heav y intoxication (26,000 pg/g, blood fat), only mild facial acne lesions occu rred. Both patients initially experienced nonspecific gastrointestinal symp toms. In Patient 1 we observed a moderate elevation of blood lipids, leukoc ytosis, anemia, and secondary amenorrhoea. The laboratory parameters in Pat ient 2 were all normal. Despite the high TCDD levels, apart from chloracne, only few clinical and biochemical health effects were observed within the first 2 years after TCDD intoxication.