Generalized eruption with severe liver dysfunction associated with occupational exposure to trichloroethylene

Nakayama, Hiroko; Kobayashi, Misaki; Takahashi, Masaru; Ageishi, Yoshio; Takano, Takehito

doi:10.1111/j.1600-0536.1988.tb02867.x

Cited by 50 publications

(31 citation statements)

References 6 publications

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“…He continued going to work, but died fourteen days later. Nakayama et al 7) reported a patient intoxicated by the use of trichloroethylene as a degreasing agent. Two wk after commencing work, systemic erythema and liver dysfunction with high fever were observed in this patient.…”

Section: Clinical Manifestation Of Trichloroethylene-related Generalimentioning

confidence: 99%

“…Together with anesthetic action, hepatic damage, polyneuropathy, trigeminal neuropathy, and dermatitis with skin irritation are familiar diseases which occur as a result of exposure 1,2) . In addition to the non-specific skin irritation resulting by the defatting action, severer generalized dermatitis with hepatitis, which includes Stevens-Johnson syndrome and toxic epidermal necrolysis, sometimes occurs after exposure to trichloroethylene [3][4][5][6][7][8][9][10] . Such dermatitis is generally known to occur subsequent to the administration of various medicines and infections-i.e., antibiotics such as sulfonamides, anticonvulsives such as carbamazepine and phenobarbital, anti-inflammatory medications such as acetylsalicylic acid and paracetamol, anti-parasitic medications such as albendazole and tinidazole, viruses, mycoplasma, and other bacterial infections [11][12][13][14][15] .…”

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confidence: 99%

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Generalized Skin Reactions in Relation to Trichloroethylene Exposure: A Review from the Viewpoint of Drug‐Metabolizing Enzymes

Nakajima

Yamanoshita

Kamijima

et al. 2003

Journal of Occupational Health

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Generalized Skin Reactions in Relation to Trichloroethylene Exposure: A Review from the Viewpoint of Drug-metabolizing Enzymes: Tamie NAKAJIMA, et al. Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine-The literature was reviewed to study cases of intoxication with systemic dermatitis associated with exposure to trichloroethylene. The average age of patients in the reports reviewed to date was twenty-nine; these diseases were found in relatively young persons and no difference was found according to gender. Many cases occurred within one month after the onset of exposure to trichloroethylene, and were accompanied by hepatitis, jaundice, hepatomegaly or hepatosplenomegaly. Most of the patients had no history of drug abuse or herpes infection. The level of exposure to trichloroethylene was not recorded in many cases, but ranged from less than 9 ppm to 800 ppm. In the severest cases, the lesions involved mucous membranes such as the conjunctiva and oral cavity, and the patients were diagnosed with Stevens-Johnson syndrome, but the etiology of the disease after trichloroethylene exposure remains unclear. Since several drugs have also been shown to cause systemic dermatitis with hepatitis, susceptibility factors are discussed. Many patients were found to have the slow acetylator genotype of Nacetyltransferase (NAT) 2, suggesting that the NAT2 genotype is a susceptibility factor. This hypothesis may also be applicable to trichloroethylene because NAT is involved in the glutathione-mediated metabolism. (J Occup Health 2003; 45: 8-14)

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Section: Clinical Manifestation Of Trichloroethylene-related Generalimentioning

confidence: 99%

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confidence: 99%

Generalized Skin Reactions in Relation to Trichloroethylene Exposure: A Review from the Viewpoint of Drug‐Metabolizing Enzymes

Nakajima

Yamanoshita

Kamijima

et al. 2003

Journal of Occupational Health

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“…The disorders are not caused solely by drugs. A close link between occupational solvent exposure, mostly trichloroethylene (TCE), and severe generalized skin disorders has been suggested by a series of case reports [3][4][5][6][7][8][9][10][11] . Recently, the number of patients suffering from TCE-related severe skin disorders has been increasing in Asia, especially the Philippines, Singapore, Taiwan and Guangdong Province, China 10,12,13) .…”

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confidence: 99%

Human Herpesvirus 6 Reactivation in Trichloroethylene‐exposed Workers Suffering from Generalized Skin Disorders Accompanied by Hepatic Dysfunction

Huang¹,

Kamijima

Wang

et al. 2006

Journal of Occupational Health

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This study aimed at clarifying whether infectious diseases contributed to the development of rash or hepatitis in patients with trichloroethylene-related generalized skin disorders. Fifty-nine patients consecutively hospitalized between March 2002 and December 2003 and 59 healthy exposed workers selected on an age-matched basis in the patients' factories were enrolled in the study. Information on possible risk factors for rash and hepatitis was collected with structured checklists. Antibody titers were measured for hepatitis A, B and C viruses, Mycoplasma pneumoniae, herpes simplex viruses 1 and 2, Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, measles and rubella virus. Thirty-six cases (59%) showed exfoliative dermatitis, 17 (28%) erythema multiforme, 4 (7%) StevensJohnson syndrome, and 4 (7%) toxic epidermal necrolysis. Before the onset of rash, 16 (27%) cases had received medication prescribed for the preceding fever, a main first symptom of the disorders. Marked increases in anti-human herpesvirus 6 IgG titer (≥256), which indicated viral reactivation, were noted in 14 (25%) patients, while no abnormal increase was detected in the controls (p<0.001). Anti-measles IgM titer was positive in 2 (7%) cases but not in the controls (p=0.49). The involvement of other known risk factors of rash or hepatitis was ruled out. These results suggest that part of trichloroethylene-related generalized cutaneous disorders occurring in China and drug-induced hypersensitivity syndrome overlap in terms of human herpesvirus 6 reactivation. (J Occup Health 2006; 48: 417-423)

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“…7,18 Not all patients showed a positive reaction for TCE on patch testing. In fact, we found that patch testing was negative for TCE itself, but positive for trichloroethanol, trichloroacetic acid and chloral hydrate in our patient.…”

Section: Results Of Patch Testingmentioning

confidence: 99%

Hypersensitivity syndrome due to trichloroethylene exposure: A severe generalized skin reaction resembling drug‐induced hypersensitivity syndrome

Watanabe

2011

The Journal of Dermatology

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The number of patients suffering from trichloroethylene (TCE)-related severe skin disorders with liver dysfunction has been increasing in developing countries in Asia, especially since the mid-1990s. In Japan, five cases of this disease have been reported, but none since the 1990s. However, two additional cases were recently observed in Tokyo. The published work and our investigation indicated that oxidative metabolites of TCE, which might include trichloroacetylated-protein adducts, could induce a generalized skin eruption. Furthermore, human leukocyte antigen (HLA)-B*1301 and HLA-B*44 were identified as markers of individual susceptibility to TCE-induced hypersensitivity syndrome (HS). Moreover, polymorphism of aldehyde dehydrogenase (ALDH), the major enzyme in TCE metabolism, appeared to be associated with TCE-induced HS. Interestingly, this disorder is quite similar to druginduced hypersensitivity syndrome (DIHS), also referred to as drug rash with eosinophilia and systemic symptoms (DRESS), from the perspective of the onset of the reaction after exposure to TCE ⁄ drugs, clinical manifestations, blood examination and period of virus reactivation. This article reviews the similarity between TCE-related HS and DIHS ⁄ DRESS.

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Generalized eruption with severe liver dysfunction associated with occupational exposure to trichloroethylene

Cited by 50 publications

References 6 publications

Generalized Skin Reactions in Relation to Trichloroethylene Exposure: A Review from the Viewpoint of Drug‐Metabolizing Enzymes

Generalized Skin Reactions in Relation to Trichloroethylene Exposure: A Review from the Viewpoint of Drug‐Metabolizing Enzymes

Human Herpesvirus 6 Reactivation in Trichloroethylene‐exposed Workers Suffering from Generalized Skin Disorders Accompanied by Hepatic Dysfunction

Hypersensitivity syndrome due to trichloroethylene exposure: A severe generalized skin reaction resembling drug‐induced hypersensitivity syndrome

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