Epidemiology of hexachlorobenzene-induced porphyria in Turkey: clinical and laboratory follow-up after 25 years.

Cutanea tarda and mixed porphyric symptoms resulted from accidental ingestion of hexachlorobenzene (HCB)-treated seed grain in Turkey 25 years ago and involved about 4,000 persons with a 10% mortality. Twenty-five years later, 161 patients, 63 women and 98 men, with histories of HCB exposure as children or young adults were studied. Many patients had persistent abnormal porphyrin metabolism and prominent neurological, dermatologic, and orthopedic symptoms and signs. Thyromegaly was seen in 60% of the women and 27% of the men. The children born to porphyric mothers 25 years ago all died of pembe yara secondary to maternal milk and transplacental transfer of HCB. Current lactation specimens of porphyric patients show high HCB levels, up to 3.12 ppm, but the infant offspring appear normal.