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2009.07.25 23:30 |  診療  |  その他（一般）  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

モリブデンで痛風

・モリブデンは、必須微量元素ですが、過剰な暴露により健康障害を起こします。モリブデンの一般的な解説は↓

http://hfnet.nih.go.jp/contents/detail593.html

私は、塵肺を起こすことは知っていましたが、高尿酸血症／痛風を起こすことは知りませんでした。UpToDateのSecondary hyperuricemia を起こす原因の表にもモリブデンは載っておりませんでしたが、化学物質安全性評価シートには、以下のような記載がありました。

 http://www.safe.nite.go.jp/pdf/2001-47.pdf 

 過剰障害として最も代表的な症状は、関節の痛みと痛風様症状である。モリブデンの過
剰摂取により、ヒトは家畜と同様に高尿酸血症を呈し、自覚症状のあるヒトでは血清中の
尿酸濃度と血清中のモリブデン濃度及びキサンチンオキシダーゼ活性との間に相関がみ
られる。関節の痛みの訴えと痛風様症状(過尿酸症, 紅斑、浮腫、膝・手・足の変形)のみられるアルメニアの高モリブデン土壌(77 mg Mo/kg)地域の住民(食事によるモリブデンの推定摂取量：0.14-0.21 mg/kg/day)に、血清尿酸濃度(平均81 mg/L)と組織のキサンチンオキシダーゼ活性の高いことが報告されている。尿酸濃度は居住期間と関連がみられ、1 年未満で37.5 mg/L であったものが、5 年後には68 mg/L 以上になる10, 17)。なお、米国EPA では、この研究での推定摂取量をLOAEL としてRfD 5 μg/kg/日を設定している26)。また、銅・モリブデン製造プラントで金属モリブデンに暴露された労働者に血中尿酸値の上昇と痛風様の症状がみられている。
金属モリブデン及び三酸化モリブデンに暴露されたヒトに、わずかではあるがじん肺症
の発生が認められている。

また、以下のような症例報告もあります。 

Occupational molybdenum exposure and a gouty electrician.

Selden AI, et ali.
Occup Med(Lond).2005 Mar; 55(2):145-8

BACKGROUND: Molybdenum is an essential trace element and a component of xanthine oxidase, which catalyses the formation of urate. The toxicity of molybdenum in humans is considered to be low, but hyperuricaemia and gout-like symptoms have been observed sporadically. METHODS: A case of hyperuricaemia and gouty arthritis in a young man with occupational exposure to molybdenum is described. Improvement during an exposure-free period was followed by a relapse after a reconstruction designed to quantify his molybdenum exposure. CONCLUSION: This case seems to represent the first observation of gout associated with occupational molybdenum exposure, but the association might also be entirely circumstantial.

・新臨床内科学、朝倉の内科学（ちょっと古い版）の痛風のところには、モリブデンありませんでした。ハリソン内科学書もなし。（ただし、原因として、berylliosis,lead intoxicationはあげてありました）

 

・以下日記。

本日午前中は回診とdesk work、午後から会議でした。その後イオンに行って、『エヴァンゲリオン：破』をみました。見終わったら、顎が「凝って」おりました。これは、裁判で証人に出た時以来の顎の凝りかしら．．．エヴァンゲリオン良かったです。（長女が見たとき、興奮してかえってきとりました）私のようオッサンの観客はいなかったようですが。私は、「使徒」がすき。あの、キャラや動作、色づかいがよいですね。（アクエリオンも色づかいやケルビム、なんて言ったか忘れたけど、魔法陣のような、バリアーを破る「穴」も好き）「序」ときて、「破」だから、次は「急」かと思ったら、「Ｑ］でした。次回も見るぞっ！ところで、エヴァンゲリオン＝evangelionのevangel(evangelium)は、「福音」という意味です。知ってました？だから、「使徒」が出てくるのでしょう。

 

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