's Article Keeps Popping Up Everywhere!

[Guest guest]

http://www.community-care.oaktree.co.uk/docs/me0040.txt

CHRONIC TRICHOTHECENE MYCOTOXICOSIS MAY BE INDISTINGUISHABLE FROM CFS

, RJ Lawrence Livermore National Laboratory, University of

California,

Livermore, CA 94551

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.

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

were conducted. Personal communication with key researchers in the field

and presumed victims of chronic mycotoxicosis were included.

RESULTS: In 1982, concerned that trichothecene mycotoxins may 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. Subsequently,

there have been published reports or presentations of chronic

mycotoxicosis in several homes, office buildings and a hospital. 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published report, experts in the field relate several unpublished cases.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.

Several of the published reports explicitly state that the symptom

constellation experienced by mycotoxin victims 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, 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 " . He reported evidence of

immune system impairment in many of his patients.

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 10 years. Less than 20% of the victims

reported complete recovery. Most reported some recovery. About 10% either

did not recover or became worse.

SUMMARY: 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.