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The chronic phase was preceded by an intermediate phase with many changing features and an increase of mortality due to thrombosis of large vessels and primary pulmonary hypertension. This intermediate phase lasted two months until the chronic phase started

Subsequently, scleroderma, neuropathy and sicca syndrome were the main features. Causes of mortality changed to respiratory insufficiency due to muscular weakness.

Alonso Ruiz A, Zea Mendoza AC, Salazar Vallinas JM, et al. Toxic oil syndrome: a syndrome with features overlapping those of various forms of scleroderma. Semin Arthritis Rheum 1986;15(3):200-12.

Martinez Tello FJ, Navas Palacios J, Ricoy JR, et al. Pathology of a new toxic syndrome caused by ingestion of adulterated oil in Spain. Virchows Arch [Pathol Anat ] 1982;397(3):261-85.