Journal article
Recurrent Acute Liver Failure Because of Acute Hepatitis Induced by Organic Solvents: A Case Report
Medicine (Baltimore), Vol.95(1), pp.e2445-e2445
2016
DOI: 10.1097/MD.0000000000002445
PMID: 26735550
Abstract
The authors present a case of recurrent acute liver failure because of occupational exposure to organic solvents.
A 35-year-old man with a 3-week history of worsening jaundice and flu-like symptoms was admitted to our hospital. Viral hepatitis serology and autoimmune factors were negative. The authors considered liver transplantation, but the patient's liver function spontaneously recovered. Liver biopsy revealed massive infiltration of neutrophils, but the cause of the acute hepatitis was not identified. Four months after discharge, the patient's liver function worsened again. The authors considered the possibility of antinuclear antibody-negative autoimmune hepatitis and initiated steroid treatment, which was effective. Four months after discharge, the patient was admitted for repeated liver injury. The authors started him on steroid pulse therapy, but this time it was not effective. Just before the first admission, he had started his own construction company where he was highly exposed to organic solvents, and thus the authors considered organic solvent-induced hepatitis. Although urine test results for organic solvents were negative, a second liver biopsy revealed severe infiltration of neutrophils, compatible with toxic hepatitis. Again, his liver function spontaneously improved. Based on the pathology and detailed clinical course, including the patient's high exposure to organic solvents since just before the first admission, and the spontaneous recovery of his liver damage in the absence of the exposure, he was diagnosed with toxic hepatitis. The authors strongly advised him to avoid organic solvents. Since then, he has been in good health without recurrence.
This is the first report of recurrent acute liver failure because of exposure to organic solvents, which was eventually diagnosed through a meticulous medical history and successfully recovered by avoiding the causative agents. In acute liver failure with an undetermined etiology, clinicians should rule out organic solvent-induced hepatitis.
Details
- Title: Subtitle
- Recurrent Acute Liver Failure Because of Acute Hepatitis Induced by Organic Solvents: A Case Report
- Creators
- Daisuke Ito - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Tomohiro Tanaka - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Nobuhisa Akamatsu - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Kyoji Ito - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Kiyoshi Hasegawa - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Yoshihiro Sakamoto - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Hayato Nakagawa - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Hidetaka Fujinaga - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)Norihiro Kokudo - From the Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo (DI, NA, KI, KH, YS, NK); Organ Transplantation Service, University of Tokyo Hospital (TT); and Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan (HN, HF)
- Resource Type
- Journal article
- Publication Details
- Medicine (Baltimore), Vol.95(1), pp.e2445-e2445
- DOI
- 10.1097/MD.0000000000002445
- PMID
- 26735550
- NLM abbreviation
- Medicine (Baltimore)
- ISSN
- 0025-7974
- eISSN
- 1536-5964
- Publisher
- Wolters Kluwer Health
- Language
- English
- Date published
- 2016
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094505902771
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