A case of severe neurotoxicity associated with exposure to 1-bromopropane, an alternative to ozone-depleting or global-warming solvents.
A case of severe neurotoxicity associated with exposure to 1-bromopropane, an alternative to ozone-depleting or global-warming solvents.
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DOI：
10.1001/archinternmed.2012.3987
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发表时间：
2012-09
影响因子：
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通讯作者：
M. Samukawa;G. Ichihara;N. Oka;S. Kusunoki
中科院分区：
文献类型：
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作者：
M. Samukawa;G. Ichihara;N. Oka;S. Kusunoki
一些国家已经发布了对1-溴丙烷的健康危害警报，这是一种破坏臭氧层的有机溶剂的替代品。在此，我们报告一例新的1-溴丙烷引起的神经毒性。一名43岁的男性产业工人出现肌肉无力、疼痛、麻木和步态障碍。神经学检查显示感觉性共济失调神经病伴有轻度上运动神经元损伤。他在工作场所使用1-溴丙烷作为金属部件的清洗剂，没有适当的保护措施。在出现临床症状时，血清溴化物水平升高。腓肠神经活检组织病理学检查显示轴突受损。在被初步诊断为1-溴丙烷中毒的情况下，他被禁止接触到这种溶剂。这导致了症状的逐渐改善，运动功能的恢复，以及感觉障碍的解决。此病例中1-溴丙烷神经中毒的诊断是基于工作环境、临床病程、实验室和病理结果的详细情况。据我们所知，这是第一个描述人类病例神经活检结果的报告。
Health hazard alerts to 1-bromopropane, an alternative to ozone layer-damaging organic solvents, have been issued by some countries. Herein, we report a new case of 1-bromopropane-induced neurotoxicity. A 43-year-old male industrial worker developed muscle weakness, pain, numbness, and gait disturbance. Neurological examination indicated sensory ataxic neuropathy associated with mild impairment of upper motor neurons. He had used 1-bromopropane as a cleaning agent for metal parts at his workplace without appropriate protection. The serum bromide level was elevated at the onset of clinical manifestations. Histopathologic examination of sural nerve biopsy showed axonal damage. Under the tentative diagnosis of 1-bromopropane toxicity, he was kept away from exposure to the solvent. This resulted in gradual improvement of symptoms, recovery of motor function, and resolution of sensory deficits. The diagnosis of 1-bromopropane neurotoxicity in this case was based on details of the work environment, the clinical course, and laboratory and pathologic findings. To our knowledge, this is the first report that describes nerve biopsy findings in a human case.