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March 1985

Toxic Oil Syndrome

Arch Intern Med. 1985;145(3):578. doi:10.1001/archinte.1985.00360030230057

To the Editor.  —The study by Gilsanz et al1 on the evolution of 317 patients suffering from toxic oil syndrome (TOS) includes a number of data on which we would like to comment.First, we are surprised by the low incidence of eosinophilia (40%) in relation to other series,2 which even reached 98%. In 1,500 patients followed up by us, eosinophilia appeared in 86.4% of the patients. Similarly, we noticed the lack of data on hepatopathy. In our series, during the first six months, 20.1% of the patients had hepatopathy, after one year 21.5%, and after two years 19%. The clinical data demonstrate cytolytic, cholestatic, and mixed patterns. This affection corresponds to histologic alterations,3 with inflammatory, degenerative, and microscopic cholestatic changes.The incidence of mitral prolapse in the series referred to by Gilsanz et al was 21% (4/19) and not 31% which, because of the small number