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Urinary 2,5-hexanedione excretion in cryptogenic polyneuropathy compared to the general Swedish population
Skåne University Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
University of Perugia, Italy.
Ryhov County Hospital, Sweden.
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2013 (English)In: Journal of Occupational Medicine and Toxicology, ISSN 1745-6673, Vol. 8Article in journal (Refereed) Published
Abstract [en]


2,5-hexanedione (2,5-HD) is the main neurotoxic metabolite of methyl-n-butyl ketone (MBK) and n-hexane, and known to cause polyneuropathy. The aim of our study was to compare the urinary levels of 2,5-HD between cases with cryptogenic polyneuropathy and the general Swedish population, and to elucidate the role of certain external factors.


Morning urine samples were collected from 114 cases with cryptogenic polyneuropathy (77 men and 37 women) and 227 referents (110 men and 117 women) randomly selected from the population registry. None had any current occupational exposure to n-hexane or MBK. The urine samples were analysed by a gas chromatographic method based on acidic hydrolysis.


Cases had statistically higher urinary levels of 2,5-HD (0.48 mg/L) than the general population (0.41 mg/L) and men higher excretion than women (0.48 mg/L and 0.38 mg/L, respectively). There was no difference in 2,5-HD levels between current smokers and non-smokers. Occupational exposure to xylene, alcohol consumption and ever exposed to general anaesthesia were associated with lower excretion in men while for occupational exposure to nitrous oxide in women higher excretion was seen. Higher excretion of 2,5 HD was inversely related to increasing age.


Significantly higher levels of urinary 2,5-HD were seen in men and cryptogenic polyneuropathy cases seemingly unexposed to n-hexane. Hypothetically, this might be due to either differences in metabolic patterns or some concealed exposure. The difference in means between cases and the general population is small and can therefore not allow any firm conclusions of the causality, however.

Place, publisher, year, edition, pages
BioMed Central , 2013. Vol. 8
Keyword [en]
Polyneuropathy, Cryptogenic, Urine, 2, 5-hexanedione, General population, Sweden, Occupational exposure
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-96984DOI: 10.1186/1745-6673-8-21ISI: 000322598500001OAI: diva2:644948

Funding Agencies|Swedish Council for Work Life and Social Research||Medical Research Council of Southeast Sweden (FORSS)||

Available from: 2013-09-02 Created: 2013-09-02 Last updated: 2013-10-08

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Vrethem, MagnusHällsten, Anna-LenaFredrikson, Mats
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NeurologyFaculty of Health SciencesDepartment of NeurologyOccupational and Environmental MedicineOccupational and Environmental Medicine CenterDivision of Inflammation Medicine
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