Subacute Myelo-Optico-Neuropathy (SMON) and Chinoform
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概要
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SMON is a new disease with characteristic clinical features. Pathologically pseudosystemic degeneration of spinal cord and peripheral nerve is prominent, which suggests its etiology to be due to toxins or nutritional deficiency. Recently green tongue and green feces have been noticed in many SMON patients, in parallel with the neurological symptoms. In last May, 1970, green urine was found in 2 SMON patients, in which needle-like crystals were detected. These crystals were confirmed by Prof. Tamura to be of unconjugated chinoform, and the green substance was its iron (III) chelate. From this detection, the idea that chinoform may be a causative agent of SMON was advocated, and the supporting results have since been obtained by us, as follows:<BR>1) Almost all SMON patients had taken chinoform prior to the onset of the disease and appearance of SMON in the group of the patients who had not taken chinoform were exceptional.<BR>2) Close relationship between the administered amount of chinoform and the onset of SMON was confirmed in Toda-Warabi area. This finding was supported by a survey in Tokyo area.<BR>3) Rarity of SMON in children could be explained from the viewpoint of the dose of chinoform, because it was confirmed in 4 pediatric clinics that chinoform was rarely administered and its long term administration was exceptional in children.<BR>4) SMON-Like features in rabbits were obtained by a small dose of chinoform i. v. and per os. The pathological findings of the peripheral nerves were similar to that of SMON.<BR>5) Abdominal symptoms of SMON were confirmed, consisted of ordinary abdominal complaints before chinoform administration and abdominal distress after the administration.<BR>6) Recently SMON-like patients have been reported in other countries to be suspicious of chronic chinoform intoxication. It could be suggested that more SMONlike patients may exist than supposed in foreign countries.<BR>7) Since discontinuance of chinoform administration in September 1970, no new appearance of SMON has been reported in Tokyo area. Although some problems remain to be settled, it can be suggested that chinoform is the causative agent of SMON.
- Japan Society of Clinical Chemistryの論文
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