Delayed head and neck complications of sulphur mustard poisoning in Iranian veterans

Zojaji, Ramin; Balali-Mood, Mahdi; Mirzadeh, Morteza; Saffari, Ahmad; Maleki, Mohammad Reza

doi:10.1017/s0022215109990260

Cited by 15 publications

(7 citation statements)

References 17 publications

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“…We found no malignancy on the upper respiratory tract in these patients, but our otolaryngologist and associates 24 have reported a case of nasopharyngeal carcinoma in a 38-year-old man 12 years after SM exposure and two male patients 34 and 36 years old with thyroid carcinoma 12 and 14 years after SM exposure, respectively. Easton and his colleagues 14 have also reported cases of laryngeal carcinoma of the British SM factories.…”

Section: Upper Respiratory Complicationscontrasting

confidence: 51%

Delayed toxic effects of sulfur mustard on respiratory tract of Iranian veterans

et al. 2010

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To investigate late toxic effects of sulfur mustard (SM) on the upper and lower respiratory tracts of Iranian veterans, 43 male veterans with more than 25% disability due to SM poisoning in 20−25 years after exposure, were studied. Direct laryngoscopy, pulmonary function tests, arterial blood gasses and pH, computed tomography of sinuses and lungs were investigated. The patients were aged 50.6 (8.9 SD) years with body mass index (BMI) of 26.6 (4.0) and disability of 53.2 (17.0%). The common findings of the upper respiratory tract were dysphonia (79.1%), post-nasal discharge (PND; 41.9%), lower larynx position (30.2%), limitation of vocal cords (25.6%) and mucosal inflammation of larynx (14.8%). The common lower respiratory diseases were diagnosed as chronic obstructive respiratory disease (84%), bronchiectasis (44.1%) and lung fibrosis (7.7%). Severity of disability was negatively correlated with BMI ( p = 0.032), spirometric parameters ( p < 0.001) and oxygen saturation ( p < 0.001), but positively correlated with low-density lipoproteins (LDL <0.010), blood pressure ( p = 0.008), diabetes mellitus ( p < 0.001), wheezing ( p = 0.0043) and bronchiectasis ( p < 0.001). Delayed toxic effects of SM in upper and lower respiratory tracts were mostly inflammatory and infectious complications, SM-induced disabilities were significantly correlated with risk factors such as diabetes mellitus, hypertension, LDL and lower-respiratory complications.

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Section: Upper Respiratory Complicationscontrasting

confidence: 51%

Delayed toxic effects of sulfur mustard on respiratory tract of Iranian veterans

et al. 2010

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“…The delayed toxic effects of SM were documented in Iranian veterans, focusing on head and neck complications. For the first time, they reported carcinomas of thyroid and nasopharynx in patients with SM exposure (8). Despite the decrease in T3 level in most of these reports, different elucidations could interpret the elevation of T3 in our study; one is that more subjects in our control group have lower level of T3 than normal range (11.8% in control and 4.3% in exposed).…”

Section: Discussioncontrasting

confidence: 54%

“…Numerous mechanisms have been proposed, including changes in the expression of a large number of potential target genes or proteins, altered by EDCs (14). Activation of EDCs may interfere with thyroid function by interfering with thyroid hormone synthetic pathways, deiodinase functions in peripheral tissues, altering TH turnover, and carrying proteins in the blood (6,8,13,(15)(16)(17)(18)(19). However, the limitation of this study is that as our subjects were selected from a previous large cohort study, detailed clinical evaluation in view of specific thyroid assessment was not performed.…”

Section: Discussionmentioning

confidence: 99%

Serum Concentration of Thyroid Hormones Long-Term After Sulfur Mustard Exposure

Moaiedmohseni¹,

Ghazanfari²,

Mirsharif³

et al. 2019

ijph

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Background: Despite several reports on the clinical manifestations of sulfur mustard (SM) intoxication, there is no study on serum concentrations of thyroid hormones long-term after SM exposure. In this study, the changes in thyroid functioning parameters 20 yr after SM exposure were evaluated. Methods: This study is a part of a larger historical cohort study conducted in 2007 following 20 years of the exposure to SM, called Sardasht–Iran cohort study (SICS). We (SICS) comprised an SM–exposed group from Sardasht City, West Azerbaijan Province, Iran (n=169 as hospitalized group and n=203 as non-hospitalized exposed group); and control participants were selected from Rabat, a town near Sardasht (n=126). Peripheral blood samples were taken in fasting state and then the sera were separated. T4, T3, TSH, antithyroglobulin (anti–Tg), and antithyroid peroxidase (anti–TPO) concentrations in the sera were measured by the ELISA method. Results: The mean of T3 concentration was significantly higher in the exposed than control group (0.88 ± 0.26 nmol/L vs 0.8 ± 0.25 nmol/L, P<0.001). The levels of TSH, T4, and T3up were not significantly different between the exposed and control groups. Thyroglobulin level was significantly higher in the exposed non-hospitalized group (56.07 ± 140.22 µg/L vs 17.66 ± 41.49 µg/L, P=0.004), but the level of anti–Tg and anti–TPO showed no significant differences between the two groups. Conclusion: More studies are needed on the alterations in thyroid hormones, their gene expressions, and mechanisms involved in SM exposure to clarify the causes of these alterations.

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“…SM affects the heart, nervous and digestive systems . However, SM exposure mostly affects lungs, peripheral nerves, skin and eyes . Lungs are a major target of SM; lungs exposure to SM leads to bronchial tissues destruction .…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…20,21 However, SM exposure mostly affects lungs, peripheral nerves, skin and eyes. 22 Lungs are a major target of SM; lungs exposure to SM leads to bronchial tissues destruction. 23 airways obstruction 24 and oxidative stress.…”

mentioning

confidence: 99%

Carvacrol ameliorates haematological parameters, oxidant/antioxidant biomarkers and pulmonary function tests in patients with sulphur mustard‐induced lung disorders: A randomized double‐blind clinical trial

2018

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Delayed head and neck complications of sulphur mustard poisoning in Iranian veterans

Abstract: Carcinomas of the thyroid and nasopharynx in three patients with sulphur mustard exposure are reported for the first time.

Cited by 15 publications

References 17 publications

Delayed toxic effects of sulfur mustard on respiratory tract of Iranian veterans

Delayed toxic effects of sulfur mustard on respiratory tract of Iranian veterans

Serum Concentration of Thyroid Hormones Long-Term After Sulfur Mustard Exposure

Carvacrol ameliorates haematological parameters, oxidant/antioxidant biomarkers and pulmonary function tests in patients with sulphur mustard‐induced lung disorders: A randomized double‐blind clinical trial

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