what was used to treat viktor yushchenkos dioxin poisoning
When Ukrainian presidential candidate Viktor Yushchenko was diagnosed as suffering from dioxin poisoning, with the second highest blood level ever recorded, he entered medical history as 1 of the few humans whose exposure to that amanuensis was manifestly deliberate. In fact, the medical literature contains but two other cases of intentional dioxin poisoning, cases that were never solved, producing symptoms lasting for years, and that were treated with doses of Pringle's Fat-Free Potato Chips.
Merely I'grand getting ahead of myself.
Dioxin isomers are highly lipophilic, accumulate in fat, and can have elimination one-half-lives lasting years
Mr. Yushchenko apparently became ill on Sept. 6, 2004, with headache and abdominal hurting. The previous night he had dined with the chief and deputy chief of S.B.U., the Ukrainian Secret Service. Whether this was a coincidence is a thing of dispute. Although clinical experience is limited, some experts believe that symptoms of dioxin poisoning do not brainstorm immediately upon exposure but but subsequently a delay of several days to several weeks. (A recent news written report suggests that Mr. Yushchenko's symptoms may have begun even before the Sept. 5 dinner.)
,3,7,viii-tetrachlorodibenzo-p-dioxin
By Sept. 10, the symptoms had become so astringent that Mr. Yushchenko was flown to Rudolfinerhaus Hospital in Vienna, where he was admitted with severe abdominal hurting and inability to walk. He was described every bit beingness groggy, and having an unusual grayish tinge to his skin. He also had paralysis of the left side of his confront. Laboratory tests revealed pancreatitis, abnormally loftier liver enzymes, and an elevated white claret count. His entire alimentary canal was studded with ulcers.
No single medical status seemed to explain his presentation, and tests for some obvious poisons with prominent gastrointestinal effects, such as arsenic, were negative. Viii days afterwards he arrived in Vienna, Mr. Yushchenko left the hospital confronting medical advice to resume his campaign.
He returned ten days afterwards with back pain so severe it could be controlled only with morphine administered through an epidural catheter inserted into the thoracic spine. By this time, his facial advent had undergone a remarkable transformation. His pare, notwithstanding dusky grey, was now covered with multiple cysts and inflammatory lesions, looking something similar the worst example of acne imaginable. By this time, poisoning was strongly suspected. Farther tests were needed, just because of the campaign, Mr. Yushchenko could not render to Vienna until tardily autumn. Finally, on Dec. 11, the diagnosis was announced. The hitting skin changes were manifestations of chloracne. Viktor Yushchenko had been poisoned with dioxin.
TCDD Poisoning
Dioxin is non a unmarried chemical, but rather a grouping of more 70 cyclic organic compounds containing chlorine, the most toxic of which is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). It is possible that the exact mix of dioxin isomers constitute in Mr. Yushchenko'due south tissues may allow the poison to be traced dorsum to a specific source. These chemicals are not natural, but are formed as byproducts of certain manufacturing processes such as those used to brand pesticides and antiseptics. They are highly lipophilic, accumulate in fat, and tin accept elimination half-lives lasting years.
Chloracne is a distinct skin condition whose feature changes are produced simply by exposure to halogenated cyclic hydrocarbons. Features of chloracne include:
- ▪ Prominence of rash on lateral sides of eyes and behind the ears.
- ▪ Relative sparing of nose (non truthful in Mr. Yushchenko's case).
- ▪ Presence of comedones (blackheads) and small harbinger-colored cysts that may become inflamed and enlarged as the affliction progresses.
- ▪ Conjunctivitis.
- ▪ Lag of two to four weeks from exposure to advent of peel lesions.
Dioxin poisoning itself oftentimes causes hepatic inflammation, elevated g-GT, peripheral neuritis, and leukocytosis — all findings present in Mr. Yushchenko. Because dioxins have such long one-half-lives, once the diagnosis is suspected, information technology is relatively piece of cake to demonstrate the causative agent in the blood. Mr. Yushchenko'south claret dioxin level was the second highest on record — 100,000 pg per gram of blood fat. By comparing, the typical background level in the population is x to 45 pg per gram.
Ukrainian presidential candidate Viktor Yushchenko, left, in March 2002, and at right this past Dec after he was poisoned with dioxin.
There is considerable experience with dioxin exposure equally a issue of industrial accidents. For example, a 1976 leak at the Icmesa hexachlorophene factory in Seveso, Italy, exposed tens of thousands in the surrounding cities to TCDD. Some, by and large children and adolescents, developed chloracne, but in virtually all the manifestations of TCDD toxicity were mild and cocky-limited. Cases of intentional, massive exposure are extremely rare.
The two other such cases reported in the medical literature occurred in Vienna. In the bound of 1998, 2 women working in a textile institute presented with chloracne, which had been preceded by gastrointestinal symptoms. The more seriously affected patient had hundreds of cysts on her face and in areas non usually involved in acne eruptions — the ears, eyelids, limbs, and genital region. Her blood dioxin level was 144,000 pg per gram of claret fatty. She was initially treated with topical tretinoin without benefit.
Additional treatment included surgical removal of pare lesions, steroids, antibiotics, and analgesics. Considering the nonabsorbable fat substitute olestra increases fecal excretion of TCDD (by bounden and trapping it in the gut), both patients were given multiple doses over 38 days in the grade of Pringle'due south Fatty-Free chips (ten gm olestra/28 g chips). Although this did increment clearance of TCDD, the clinical effects of this increase were not known, and both patients eventually found the regimen unpalatable. Other ways of removing fat from the trunk — liposuction, induced lactation — were discussed but non attempted. The source of exposure was never identified.
These cases are described in Environmental Health Perspectives (2001;109:865). The article, along with color pictures of the skin lesions, can be found online at http://ehp.niehs.nih.gov/members/2001/109p865-869geusau/geusau-full.html.
Although Viktor Yushchenko has survived the worst stage of astute dioxin poisoning, he might continue to experience dermatological bug for some time. One of the Vienna victims was still requiring surgical treatment of her pare lesions three years later exposure.
Source: https://journals.lww.com/em-news/Fulltext/2005/02000/Yushchenko,_Victim_of_Dioxin_Poisoning,_Faces.22.aspx
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