Cryoglobulinemia in Raynaud's phenomenon due to vinyl chloride

Langauer-Lewowicka, H; Dudziak, Z; Byczkowska, Z; Marks, Janet

doi:10.1007/bf00378274

Cited by 11 publications

(4 citation statements)

References 13 publications

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“…The importance of immunological mechanisms in vinyl chloride disease has been pointed out by some authors. [16][17][18] This on the basis of findings in workers exposed to vinyl chloride (presence of circulating immune complexes and autoantibodies against various tissue components; 16 cryoglobulinemiaI6,I7) and results of experimental studies (blast formation of lymphocytes in splenic cell cultures of mice exposed to vinyl chloride'8). Ward et al proposed a theoretical model based on alkylating VC intermediates -mainly the epoxide metabolite chloroethylene oxide -which bind covalently to plasma proteins, thus functioning as hapten with stimulation of antibody response.…”

Section: Discussionmentioning

confidence: 98%

Vasculitic Purpura in Vinyl Chloride Disease: A Case Report

Magnavita¹,

Bergamaschi²,

Garcovich³

et al. 1986

Angiology

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Vinyl chloride (VC), a volatile substance mostly used for polyvinyl chloride (PVC) synthesis, is a systemic toxicant particularly noxious to endothelium. Angiosarcoma of the liver, Raynaud's phenomenon, scleroderma-like lesions, acroosteolysis and neuritis are known to be typical vinyl chloride-associated manifestations (VC disease). A so far unknown feature of the disease is purpura. This was first observed by the authors in a worker of a PVC-producing plant. The skin eruption was characterized by small purpuric maculae with tiny, palpable spots and papulae, mostly concentrated on the lower part of the legs, changing into bullae, pustules and crusts and tending to spontaneous regression after withdrawal from VC exposure. A skin biopsy revealed marked inflammatory reaction with a mostly lymphocytic and histiocytic infiltration around and in the walls of dermal arterioles. The finding of increased circulating immune complexes and anti-smooth muscle autoantibodies strengthens the hypothesis that immunologic changes play a role in the appearance of "vinylic purpura."

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Section: Discussionmentioning

confidence: 98%

Vasculitic Purpura in Vinyl Chloride Disease: A Case Report

Magnavita¹,

Bergamaschi²,

Garcovich³

et al. 1986

Angiology

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“…However, studies suggest that VC-induced Raynaud disease may, in part, be triggered by immune complex deposition. A study examining 22 patients with a history of VC exposure, who subsequently developed Raynaud disease, detected cryoglobulins in 81% of sera samples with cryoglobulinemia occurring, in part, due to hyperactivation of humoral responses following the exposure [34]. Disturbances in humoral immunity are likely to also play a role in the systemic effects of VC, including hepatotoxicity and neurologic disease [2].…”

Section: The Dermatological Effects Of Vc Exposurementioning

confidence: 99%

Public Health Risks, Dermatological Manifestations, and Environmental Justice Associated With Vinyl Chloride Exposure: Narrative Review

Goodman¹,

Mittal²,

Parker³

2023

JMIR Dermatol

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Background Environmental vinyl chloride (VC) exposure may result in serious acute and chronic dermatological conditions. Because existing literature largely focuses on exposures in occupational settings, a gap persists in our understanding of the medical consequences of large-scale chemical spills. Objective This study aims to examine the potential dermatological manifestations of VC exposure in the context of industrial spills and other environmental disasters and to highlight the public health and justice implications of such releases. Methods In this narrative review, relevant evidence-based, peer-reviewed scientific sources, gray literature, and media reports were identified via searches of search PubMed and Google using predetermined keyword search terms related to VC, VC spills and releases, train derailment, cutaneous disease, public health, and vulnerable and marginalized populations. Results Contact dermatitis and frostbite may arise acutely, highlighting the importance of swift decontamination. Long-term manifestations from chronic VC exposure due to persistence in environmental reservoirs include Raynaud disease, sclerodermatous skin changes, acro-osteolysis, and cutaneous malignancies. The clinical severity of cutaneous manifestations is influenced by individual susceptibility as well as duration, intensity, and route of exposure. Additionally, chemical releases of VC more frequently impact Communities of Color and those of lower socioeconomic status, resulting in greater rates of exposure-related disease. Conclusions With environmental release events of hazardous chemicals becoming increasingly common and because the skin has increased contact with environmental toxins relative to other organs, an urgent need exists for a greater understanding of the overall short- and long-term health impacts of large-scale, toxic exposures, underscoring the need for ongoing clinical vigilance. Dermatologists and public health officials should also aim to better understand the ways in which the disproportionate impacts of hazardous chemical exposures on lower-income and minority populations may exacerbate existing health disparities. Herein, we describe the health implications of toxic releases with particular consideration paid to marginalized and vulnerable populations. In addition to legal and regulatory frameworks, we advocate for improved public health measures, to not only mitigate the risk of environmental catastrophes in the future, but also ensure timely and effective responses to them.

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“…Latent cryoglobulinemia was detected in 18 cases, with increases of immununoglobulins, IgA and IgG (18).…”

Section: Similar Histologic Lesions Had Been Previously Described In mentioning

confidence: 99%