Chronic Trichothecene Mycotoxicosis May Be .......

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Chronic Trichothecene Mycotoxicosis May Be Indistinguishable From CFS

By R.J.

Objective: Chronic exposure to trichothecene mycotoxins (mold-produced

toxins) is known to be both immunotoxic and neurotoxic in animal studies.

Accidental exposure to these toxins can occur when toxigenic molds grow in

buildings

and release spores into the air. The objective of this research was to review

the available evidence which suggests that chronic inhalation of certain

mycotoxins produces a constellation of symptoms and laboratory abnormalities

consistent with the Chronic Fatigue Syndrome (CFS).

Method: Both a hand-search and a MedLine-based search of the literature were

conducted. Personal communications with key researchers in the field and

presumed victims of chronic mycotoxicosis were included.

Results: In 1982, concerned that trichothecene mycotoxins might be used as a

chemical warfare agent, the Department of the Army commissioned the National

Research Council to review the available literature on the potential health

effects of exposure to trichothecene mycotoxins. They concluded that there

was no well-defined cohort of people that had been exposed via inhalation, the

presumed route of interest on the battlefield. Thus the potential health

effects of inhalation exposure were not known.

In 1986 Croft et al., with funding from the Army, reported chronic

inhalation mycotoxicosis in a household in Chicago. (See " Airborne Outbreak of

Trichothecene Toxicosis " in Atmospheric Environment 20: 549-552.) Subsequently,

reports or presentations of chronic mycotoxicosis in several homes, office

buildings and a hospital have been published. For every published report,

experts

in the field relate several unpublished cases.

In California, two episodes involving groups of residences have been

reported in the lay press since 1994. Most, but not all cases have involved

molds

which produce trichothecene-class mycotoxins. Sev-eral of the published reports

explicitly state that the symptom constellation experienced by mycotoxin

vic-tims is similar or identical to CFS. Almost all of the published reports

are

consistent with a diagnosis of CFS.

At a 1994 conference dedicated primarily to mycotoxigenic fungi, Pierre L.

Auger reported that most of his patients met the 1988 CDC criteria for CFS.

Cognitive impairment was significant. He referred several of these victims to

an occupational neurologist, who diagnosed them with " toxic encephalopathy. "

Auger reported evidence of immune system impairment in many of his patients.

Eckardt Johanning reported evidence for immune dysfunction in a cohort from an

office building in New York. In addition to laboratory findings such as

reduced natural killer cell number, clinical findings included recurrent

vaginal

candidiasis and bacterial infections. Several of his cases were severely

disabled.

Although longitudinal data on patients is very limited, at least one cohort

has been followed for ten years. Fewer than 20% of the victims reported

complete recovery. Most reported some recovery. About 10% either did not

recover

or became worse.

Most aspects of chronic trichothecene mycotoxicosis are consistent with CFS,

including the symptoms, laboratory findings and recovery profile. It is

suggested that further research is warranted to determine if a subgroup of

patients diagnosed with CFS are actually suffering from mycotoxicosis.

References

Johanning E, Morey PR, Jarvis B (1993): Clinical-Epidemiological

Investigation of Health Effects Caused by Stachybotrys atra Contamination. In

Seppanen

O, Steri J, Kainlauri E (eds): " Indoor Air 93 " Helsinki: FiSIAQ, 1:225.

Printed with permission from RJ , Lawrence Livermore National

Laboratory, University of California at Livermore.

____________________________________

©Abbey Publications, Inc. 2000-2004

Last update: Wednesday, December 18, 2002 at 5:06:02 PM.

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Thank you for posting this information. There was so much info. that I

had never seen before (some old but still valid).

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