Acute liver failure caused by occupational exposure to HCFC-123
Acute liver failure caused by occupational exposure to HCFC-123
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职业接触 HCFC-123 引起的急性肝功能衰竭
DOI：
10.1097/md.0000000000014522
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发表时间：
2019
期刊：
影响因子：
1.6
通讯作者：
Jin
中科院分区：
文献类型：
--
作者：
Hun;Soomin Ahn;K. Jung;Jin
基本原理：氯氟烃123（HCFC-123，氟利昂123; 2，2-二氯-1，1，1-三氟乙烷）由于其较低的臭氧消耗潜能而被广泛用于制冷和传热应用中作为氯氟烃的替代品。职业性接触HCFC-123可引起轻度可逆性肝毒性，但尚未报告致死病例。患者关注：在本报告中，我们介绍了HCFC-123导致的具有致死性结局的重型肝炎病例。一家使用HCFC-123的灭火器制造厂的两名产业工人出现腹泻、发烧、肌痛和黄疸。在症状发作之前，患者在过去三周内反复暴露于液体形式的HCFC-123。诊断：血液生化检查显示急性胆汁淤积性肝炎，肝活检结果显示炎性肝细胞损伤。诊断为HCFC-123引起的肝炎。干预措施：两例患者的治疗一般都是支持性的。第2例患者在重症监护室接受血液透析、净化治疗和人工肝支持治疗（分子吸附再循环系统）。成果：1例患者顺利恢复，而另1例患者病情迅速恶化，导致急性肝衰竭并发脑水肿、硬膜下出血，并在住院第10天死亡。经验教训：HCFC-123诱导的肝炎与氟烷肝炎有相似之处，两者可能具有相同的病理生理机制。需要将接触HCFC-123列为急性肝衰竭的潜在原因，并在病因不明和病毒血清学阴性的急性肝炎患者中予以考虑。
Rationale: Hydrochlorofluorocarbon 123 (HCFC-123, Freon123; 2,2-dichloro-1,1,1-trifluoroethane) has been widely used in refrigeration and heat-transfer applications as a substitute for chlorofluorocarbons due to its lower ozone-depleting potentials. Occupational exposure to HCFC-123 may cause mild reversible hepatoxicity, but no fatal cases have been reported yet. Patient concerns: In this report, we present cases of severe hepatitis with fatal outcome by HCFC-123. Two industrial workers from a manufacturing factory of fire extinguishers which use HCFC-123 were presented with diarrhea, fever, myalgia, and jaundice. Patients had been repeatedly exposed to the liquid form of HCFC-123 for the past three weeks before flare of symptoms. Diagnosis: The blood biochemistry tests showed acute cholestatic hepatitis and liver biopsy findings indicated inflammatory hepatocellular injury. The diagnosis of HCFC-123 induced hepatitis was made. Interventions: The treatment for both patients were generally supportive. The second patient went through hemodialysis, ventilatory care, and artificial liver support therapy (molecular adsorbent recirculating system) at intensive care unit. Outcomes: One patient recovered uneventfully, whereas the other patient showed rapid deterioration leading to acute liver failure complicated with cerebral edema, subdural hemorrhage, and death on hospital day 10. Lessons: The HCFC-123-induced hepatitis showed similarities with halothane hepatitis, both of which may share pathophysiologic mechanisms. Exposure to HCFC-123 needs to be listed as a potential cause of acute liver failure, and to be considered in patients with acute hepatitis of uncertain etiology and negative viral serology.
2,2-二氯-1,1,1-三氟乙烷 (HCFC-123) 的气体吸收药代动力学。
DOI：
--
发表时间：
1994
期刊：
Drug metabolism and disposition: the biological fate of chemicals
影响因子：
--
作者：
Loizou,GD;Urban,G;Dekant,W;Anders,MW
通讯作者：
Anders,MW