Aplastic anemia in a professional musician exposed to instrument polish

Int J Hematol. 2005 May;81(4):304-6. doi: 10.1532/IJH97.E0420.

Abstract

Chemicals are known to cause toxin-induced aplastic anemia. However, some chemicals documented in only a few cases to possess only a possibility of toxic potential may also be responsible for the development of aplastic anemia. This report presents a case of a string musician with bone marrow failure. The patient used a certain type of polish (komalak) to shine his musical instrument and did this frequently. He presented with nasal bleeding, and a workup on admission revealed pancytopenia. Aplastic anemia was diagnosed on the basis of bone marrow histology results. An analysis for gene polymorphism related to the metabolic detoxification enzymes glutathione S-transferase and N-acetyltransferase 2 indicated that the patient was genetically susceptible to developing toxicity. This case suggests that frequent use of this polish may cause a toxic effect that leads to bone marrow failure. Musicians should be made aware of the risks associated with these types of chemicals.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Aplastic / chemically induced*
  • Arylamine N-Acetyltransferase / genetics
  • Glutathione Transferase / genetics
  • Humans
  • Industrial Oils / adverse effects*
  • Male
  • Music
  • Occupational Exposure*
  • Polymorphism, Genetic

Substances

  • Arylamine N-Acetyltransferase
  • NAT2 protein, human
  • Glutathione Transferase