Immune Thrombocytopenia in a worker exposed to toluene: a case report
Introduction: Immune thrombocytopenia (ITP) is the most common cause of isolated thrombocytopenia in healthy individuals and can be classified as either primary or secondary. Drug use is an identifiable underlying cause for ITP. Toluene is a widely used solvent that is often contaminated with small...
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Mashhad University of Medical Sciences
2024-12-01
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| Series: | Asia Pacific Journal of Medical Toxicology |
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| Online Access: | https://apjmt.mums.ac.ir/article_25257_4d8f6086e1efbf4be7e0fd277a652e3e.pdf |
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| author | Eric Slawka Margarida Lourenço Castelló Gabriel Machado Romão da Silva Angelica dos Santos Vianna |
| author_facet | Eric Slawka Margarida Lourenço Castelló Gabriel Machado Romão da Silva Angelica dos Santos Vianna |
| author_sort | Eric Slawka |
| collection | DOAJ |
| description | Introduction: Immune thrombocytopenia (ITP) is the most common cause of isolated thrombocytopenia in healthy individuals and can be classified as either primary or secondary. Drug use is an identifiable underlying cause for ITP. Toluene is a widely used solvent that is often contaminated with small amounts of benzene, a hematotoxic agent that can cause thrombocytopenia. Herein, we report a case of ITP in a patient with long-term low-level exposure to toluene in the workplace.Case Report: A 34-year-old white female chemistry technician presented to a teaching hospital in Rio de Janeiro, Brazil, in 2002, with a 2-year history of isolated thrombocytopenia, and low-level occupational exposure to toluene for more than a decade. She had bruises on the physical exam, and platelets count of 40.000 µL. A diagnosis of primary ITP aggravated by benzene-contaminated toluene exposure was made. The treatment included definitive removal from exposure and changes in activities, with gradual improvement in the clinical condition and platelet count, although without normalization.Discussion: We addressed the role of benzene as a toluene contaminant and an aggravating agent of primary ITP, a multifactorial disease that arises from different mechanisms. Although several substances may cause ITP, little attention has been paid to the role of toxicants such as benzene, a well-known hematotoxic agent.Conclusion: This case highlights the role of benzene-contaminated toluene in ITP. As benzene is a hematotoxic agent, we recommend that proper health and environmental evaluations should consider benzene exposure in workplaces where toluene is used. |
| format | Article |
| id | doaj-art-ef547c80d72d4883884db5d5a4e0a62f |
| institution | Kabale University |
| issn | 2322-2611 2322-4320 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Asia Pacific Journal of Medical Toxicology |
| spelling | doaj-art-ef547c80d72d4883884db5d5a4e0a62f2025-02-01T06:56:21ZengMashhad University of Medical SciencesAsia Pacific Journal of Medical Toxicology2322-26112322-43202024-12-0113415816310.22038/apjmt.2024.81731.146525257Immune Thrombocytopenia in a worker exposed to toluene: a case reportEric Slawka0Margarida Lourenço Castelló1Gabriel Machado Romão da Silva2Angelica dos Santos Vianna3Medical School, Rio de Janeiro Federal University, Rio de Janeiro, BrazilMedical School, Rio de Janeiro Federal University, Rio de Janeiro, BrazilMedical School, Rio de Janeiro Federal University, Rio de Janeiro, BrazilClementino Fraga Filho University Hospital and Collective Health Studies Institute, Rio de Janeiro Federal University, Rio de Janeiro, BrazilIntroduction: Immune thrombocytopenia (ITP) is the most common cause of isolated thrombocytopenia in healthy individuals and can be classified as either primary or secondary. Drug use is an identifiable underlying cause for ITP. Toluene is a widely used solvent that is often contaminated with small amounts of benzene, a hematotoxic agent that can cause thrombocytopenia. Herein, we report a case of ITP in a patient with long-term low-level exposure to toluene in the workplace.Case Report: A 34-year-old white female chemistry technician presented to a teaching hospital in Rio de Janeiro, Brazil, in 2002, with a 2-year history of isolated thrombocytopenia, and low-level occupational exposure to toluene for more than a decade. She had bruises on the physical exam, and platelets count of 40.000 µL. A diagnosis of primary ITP aggravated by benzene-contaminated toluene exposure was made. The treatment included definitive removal from exposure and changes in activities, with gradual improvement in the clinical condition and platelet count, although without normalization.Discussion: We addressed the role of benzene as a toluene contaminant and an aggravating agent of primary ITP, a multifactorial disease that arises from different mechanisms. Although several substances may cause ITP, little attention has been paid to the role of toxicants such as benzene, a well-known hematotoxic agent.Conclusion: This case highlights the role of benzene-contaminated toluene in ITP. As benzene is a hematotoxic agent, we recommend that proper health and environmental evaluations should consider benzene exposure in workplaces where toluene is used.https://apjmt.mums.ac.ir/article_25257_4d8f6086e1efbf4be7e0fd277a652e3e.pdftoluenebenzeneoccupational exposurepurpura thrombocytopenicthrombocytopenia |
| spellingShingle | Eric Slawka Margarida Lourenço Castelló Gabriel Machado Romão da Silva Angelica dos Santos Vianna Immune Thrombocytopenia in a worker exposed to toluene: a case report Asia Pacific Journal of Medical Toxicology toluene benzene occupational exposure purpura thrombocytopenic thrombocytopenia |
| title | Immune Thrombocytopenia in a worker exposed to toluene: a case report |
| title_full | Immune Thrombocytopenia in a worker exposed to toluene: a case report |
| title_fullStr | Immune Thrombocytopenia in a worker exposed to toluene: a case report |
| title_full_unstemmed | Immune Thrombocytopenia in a worker exposed to toluene: a case report |
| title_short | Immune Thrombocytopenia in a worker exposed to toluene: a case report |
| title_sort | immune thrombocytopenia in a worker exposed to toluene a case report |
| topic | toluene benzene occupational exposure purpura thrombocytopenic thrombocytopenia |
| url | https://apjmt.mums.ac.ir/article_25257_4d8f6086e1efbf4be7e0fd277a652e3e.pdf |
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