Chronic sequelae and irreversible injuries following acute pyrethroid intoxication.

For patients the author has observed, the majority of complaints following an acute pyrethroid intoxication disappeared after the end of exposure. Residuals frequently observed after more than 2 years were: (1) cerebro-organic disorders (reduced intellectual performance with 20-30% reduction of endurance during mental work, personality disorder), visual disturbances, dysacousia, tinnitus; (2) sensomotor-polyneuropathy most frequently in the lower legs; (3) vegetative nervous disorders (paroxysmal tachycardia, pollakisuria, increased heat-sensitivity, orthostatic hypotonia and reduced exercise tolerance due to circulatory disorder). Non-neurological symptoms include deficiency of cellular and humoral immune system established by laboratory findings: opportunistic infections, especially Candida-infections of the gastro-intestinal tract, relapsing infections of the urinary and respiratory tract, the latter often aggravating to respiratory obstruction. Most of the patients exhibit positive epi- or intracutantest against pyrethroids or pyrethrines, and acquainted sensitivity also to other antigens. Many of these patients exhibit pathological autoimmune diagnostical findings and developed autoimmune diseases as for instance scleroderma-like syndrome, myasthenia-like syndrome with progredient muscle atrophy, autoimmun-hemolysis and autoimmun-thrombocytopenic purpura.