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Alexandra Geusau,¹ Klaus Abraham,² Klaus Geissler,³ Michael O. Sator,⁴ Georg Stingl,¹ and Erwin Tschachler¹

¹Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, University of Vienna Medical School, Vienna, Austria; ²Department of Pediatric Pneumology and Immunology, Charité Children's Hospital, Humboldt University, Berlin, Germany; ³Department of Medicine, Division of Hematology, and ⁴Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, University of Vienna Medical School, Vienna, Austria

Abstract
University of Vienna and Humboldt University Berlin

A variety of health effects have been attributed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) , but little information is available on the course of a verified high-level TCDD intoxication. In this paper we describe two cases of heavy intoxication with TCDD and present a 2-year follow-up including clinical, biochemical, hematologic, endocrine, and immunologic parameters monitored in two women, 30 and 27 years of age, who suffered from chloracne due to TCDD intoxication of unknown origin. Patient 1, who had the highest TCDD level ever recorded in an individual (144,000 pg/g blood fat) , developed severe generalized chloracne, whereas in the second patient, despite heavy intoxication (26,000 pg/g blood fat) , only mild facial acne lesions occurred. Both patients initially experienced nonspecific gastrointestinal symptoms. In Patient 1 we observed a moderate elevation of blood lipids, leukocytosis, anemia, and secondary amenorrhoea. The laboratory parameters in Patient 2 were all normal. Despite the high TCDD levels, apart from chloracne, only few clinical and biochemical health effects were observed within the first 2 years after TCDD intoxication. Key words: amenorrhoea, anemia, chloracne, dioxin intoxication, endocrine effects, health effects, TCDD. Environ Health Perspect 109:865-869 (2001) . [Online 14 August 2001]

http://ehpnet1.niehs.nih.gov/docs/2001/109p865-869geusau/ abstract.html

Address correspondence to A. Geusau, University of Vienna Medical School, Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Telephone: 43-1-40400-7704. Fax: 43-1-40 31 900. E-mail: alexandra.geusau@akh-wien.ac.at

We thank N. Winker and B. Jäger from the Austrian workers compensation board (AUVA) for their support.

Received 23 February 2001 ; accepted 16 April 2001.