Benzidine 製造場從業員に観られた急性出血性膀胱炎について

Abstract

It is well known that aromatic nitrous or amido compounds cause occupational urosis, especially vesical diseases. Recently benzidine (which will be referred to as “Be” hereafter), one of these compounds, has become to be produced in Japan in large quantities as a intermediate product.In a benzidine making shop we recently observed, for urological examination, two cases of acute hemorrhagic cystitis, which disease is found in workers engaged in benzidine production.Case No. 1 is 28, while Case No. 2 is 29; both are males; they both suffered from acute hemorrhagic cystitis within 3 months after they were engaged in work. Their chief complaints consisted of erythrocyturia, pollakiuria and urodynia. There is nothing which is worth special mention regarding their family histories and anamneses.Cystoscopy of both cases showed that the base of the mucous membrane of the urinary bladder underwent pathoses which consisted of remarkable hyperemia and blood spots. Elcosis was found in Case No. 2. The kidneys were almost normal. There was nothing abnormal in the isolated urine. Radiographic findings were normal. Blood examination indicated that both cases suffered from hyperchromic anemia at the early stage and that red blood cells contained Heinz graules. Eosinocytes showed an increase to some extent with the passage of time. The urine met with positive results pertaining to the presence of urobilinogen, indican and porphyrin. The application to nitrobenzene and “Be” to the skin of Case No. 1 and Case No. 2 yielded positive and negative and negative results, respectively. However, several hours after the application of these agents to the skin, Case No. 2 was attacked with fever and complained of languor all over the body. The exacerbation of the symtoms of cystitis and erythrocyturia were seen twentyfours later. Such findings may be considered to afford evidence of the allergic theory of cystitis due to “Be”.Regarding the mechanism of cystitis due to “Be”, there are urinary, hematogenous and allergic theories. Yet from blood findings and clinical symptoms both cases may be due to benzidine poisoning. Since it may be presumed that more and more workers in this counthy will meet with such as an accident with the advance in its chemical industry, it is desirable that countermeasures should be taken from a urological point of view.