Hepatitis caused by occupational chronic exposure to trichloroethylene

Trichloroethylene (TCE) is an organic solvent used in a variety of industries for more than 60 years. Several adverse events fol- lowing acute or chronic exposure to trichloroethylene have been reported. However, TCE-induced hepatitis is very rare. We present the case of a 55-year old male who was presented with anorexia, fatigue and upper abdominal discomfort. Routine labo- ratory examination revealed marked elevation of liver enzyme val- ues. All possible causes of hepatitis were ruled out. The patient has been working as a shoemaker, in a small room of a basement, with insufficient air-exchange ; during the last 5 years he used daily a glue containing 1,1,1 trichloroethylene. The diagnosis of hepatitis was confirmed by liver biopsy. The offending agent was with- drawn. Three months later, he was "feeling well" and liver enzyme values had returned to normal. Six months after the initial biopsy, a second liver biopsy was performed and histology was markedly improved. Workers exposed to hazardous chemicals, such as trichloroethylene, must have periodic follow-up examinations. Good work practices are very important when using toxic sub- stances. In patients whose initial diagnostic workout is negative for common causes of acute or chronic hepatitis, toxic causes should be considered, with emphasis on patient's job and working condi- tions. (Acta gastroenterol. belg., 2004, 67, 355-357).