ABSTRACT
Dimethylformamide (DMF), a widely used industrial solvent, has been reported to induce subtle to clinically overt hepatotoxicity. Liver injury due to occupational exposure through inhalation and skin contact has been sporadically reported. We report a 23-year-old male who developed intermittent abdominal pain, anorexia, nausea, vomiting, chest discomfort, and general weakness for 4 days after working in a plastic-coated-glove factory. An acute hepatitis episode occurred after working in an enclosed workplace for 3 days. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis, could be excluded or were considered to be unlikely. Based on occupational history, serological examination and serial liver function examinations, the case was compatible with DMF-induced acute toxic hepatitis. Hepatotoxicity due to occupational exposure to solvents (e.g., DMF) should be considered in any patient with unexplained hepatitis. The fast improvement of the clinical symptoms and the progressive normalization of the liver function tests once the DMF exposure has been stopped, supports the diagnosis.
Subject(s)
Humans , Male , Young Adult , Abdominal Pain , Anorexia , Diagnosis , Dimethylformamide , Chemical and Drug Induced Liver Injury , Hepatitis , Hepatitis, Alcoholic , Inhalation , Liver , Liver Function Tests , Nausea , Occupational Exposure , Skin , Solvents , Thorax , VomitingABSTRACT
Asbestos exposure may cause asbestosis, pleural plaques and benign pleural disease, and may give a predisposition to malignant mesothelioma in occupationally exposed workers. This case report describes a 50-year-old man, dying from histologically confirmed, diffuse, malignant mesothelioma after asbestos exposure. As a young man, he had been exposed at the workplace to crocidolite for 2 years, but he had no other known history of occupational or environmental asbestos exposure. The patient presented with chest pain and general weakness. Computed tomography showed bilateral irregular pleural thickening along both lower lateral chest walls and a low attenuating mass in the anterior portion of the left lobe. Pathological examinations revealed that it was an epithelial type with tubulopapillary structures and it tested immunohistochemically positive for antibodies against cytokeratin, calretinin and vimentin. The patient was started on chemotherapy but he died to the disease at ten months after the first onset of the symptoms. Mesothelioma is a rare neoplasm in the general population. Nevertheless, the importance of close medical surveillance of the high-risk population is emphasized, because of increased asbestos exposure.