Korean J Occup Environ Med.  2012 Sep;24(3):304-310.

A Suspicious Case of Chloroform Induced Acute Toxic Hepatitis in Laboratory Worker

Affiliations
  • 1Department of Occupational and Environmental Medicine, Chonnam National University College of Medicine, Korea. jdmoon@chol.com

Abstract


OBJECTIVES
To report upon a case of toxic hepatitis in a worker exposed to chloroform.
METHODS
A 28-year-old female who had worked as chemical analysis engineer in a laboratory using chloroform was hospitalized due to nausea, vomiting and generalized weakness. The authors evaluated her using blood tests, abdominal CT scan and her occupational history.
RESULTS
The blood tests revealed acute toxic hepatitis. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis could be excluded. But autoimmune hepatitis couldn't be totally ruled out(ANA (++), IgG(serum) 1780 mg/dL). After admission, her symptoms improved and her liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Afterwards, however, her liver enzyme levels increased again one week after returning to her workplace. Subsequent to a job change, her liver enzyme levels reduced and normalized after eight weeks. The airbone laboratory chloroform ranged from 3.155 to 9.037 ppm.
CONCLUSIONS
The authors presume that this patient's liver injury was related to an interaction of chloroform toxicity and a predisposition to autoimmune hepatitis. The rapid improvement of the clinical symptoms and the progressive normalization of the liver function tests once the chloroform exposure eliminated supports the diagnosis.

Keyword

Toxic hepatitis; Chloroform

MeSH Terms

Adult
Chloroform
Drug-Induced Liver Injury
Female
Hematologic Tests
Hepatitis
Hepatitis, Alcoholic
Hepatitis, Autoimmune
Humans
Liver
Liver Function Tests
Nausea
Vomiting
Chloroform

Figure

  • Fig. 1 Preprocessing(25 minutes).

  • Fig. 2 Vial setting(8 minutes).

  • Fig. 3 Analytical instrument(290 minutes).


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