Etzel 2006 Pediatrician Should Know about Syndromes Exposure to Mycotoxins

[Guest guest]

What the Primary Care Pediatrician Should Know about Syndromes Associated

with Exposures to Mycotoxins

Ruth A. Etzel MD, PhD_a_

(http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B7584-4KR85KV-6 & _cover\

Date=09/30/2006 & _alid=447632988 & _rdoc=1 & _fmt= & _orig

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aDivision of Environmental and Occupational Health, Washington

University, School of Public Health and Health Services, Washington, DC

Available online 25 August 2006.

Abstract

Disease associated with exposure to mycotoxins is known as the “Great

Masquerader†of the 21st century because of its complex natural history

involving

different tissues and resembling different diseases at each stage in its

evolution. It can present with a variety of nonspecific clinical signs and

symptoms such as rash, conjunctivitis, epistaxis, apnea, cough, wheezing,

nausea,

and vomiting. Some cases of vomiting illness, bone marrow failure, acute

pulmonary hemorrhage, and recurrent apnea and/or “pneumonia†are associated

with

exposure to mycotoxins. Familiarity with the symptoms of exposure to the major

classes of mycotoxins enables the clinician to ask pertinent questions about

possible fungal exposures and to remove the infant or child from the source

of exposure, which could be contaminated food(s), clothing and furniture, or

the indoor air of the home. Failure to prevent recurrent exposure often

results in recurrent illness. A variety of other conditions, including

hepatocellular and esophageal cancer and neural tube defects, are associated

with

consumption of foods contaminated with mycotoxins. Awareness of the short- and

long-term consequences of exposures to these natural toxins helps pediatricians

to

serve as better advocates for children and families.

Parts of this review appeared previously in reference 16 and in Chapter 16, “

Mycotoxins and Human Disease†in Microbial Toxins: Molecular and Cellular

Biology, edited by Proft (Norfolk, England: Horizon Bioscience), 2005,

pp. 447-472.