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SMON: Toxicity of Clioquinol and the Status Quo Masaaki Konagaya 1 1National Hospital Organization Suzuka Hospital Keyword: キノホルム , 薬害 , 亜急性脊髄視神経ニューロパチー , 歴史 , 臨床病理像 , clioquinol , intoxication , subacute myelo-optico-neuropathy , history , clinicopathological features pp.49-62
Published Date 2015/1/1
DOI https://doi.org/10.11477/mf.1416200086
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Abstract

Subacute myelo-optico-neuropathy (SMON) is a disease characterized by subacute onset of sensory and motor disorders in the lower half of the body and visual impairment preceded by abdominal symptoms. A large number of SMON were observed throughout Japan, and the total number of cases reached nearly 10,000 by 1970.

Despite clinical features mimicking infection or multiple sclerosis, SMON was confirmed as being caused by ingestion of clioquinol, an intestinal antibacterial drug, based on extensive epidemiological studies. After the governmental ban on the use of clioquinol in September 1970, there was a dramatic disappearance of new case of SMON.

In the 1970s, patients with SMON initiated legal actions against the Government and pharmaceutical companies, and the court ruled that the settlements would be made as health management allowances and lasting medical check-ups.

The physical condition of patients with SMON remains severe owing to SMON as well as gerontological complications.

The pathological findings in patients with SMON included symmetrical demyelination in the lateral and posterior funiculi of the spinal cord and severe demyelination of the optic nerve in patients with blindness.

Although clioquinol may show activity against Alzheimer's disease or malignancy, its toxic effects cause severe irreversible neurological sequelae. Thus, caution must be exercised in the clinical use of clioquinol.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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