Karhunen P J, Ojanperä I, Lalu K, Vuori E
Department of Forensic Medicine, University of Helsinki, Finland.
Hum Exp Toxicol. 1990 May;9(3):197-200. doi: 10.1177/096032719000900315.
Fatal massive peripheral zonal hepatic necrosis developed in a 47-year-old man who accidentally ingested a solution of methyl ethyl ketone peroxide (MEKP) in dimethyl phthalate. Such solutions contain about 10% active oxygen. The clinical course was characterized by temporary cardiac arrest, abdominal burns, severe metabolic acidosis, rapid hepatic failure, rhabdomyolysis and respiratory insufficiency. A fatal outcome resulted 4 d afterwards from hepatic coma associated with blood coagulation disorders. Microscopical examination revealed massive periportal hepatic necrosis accompanied by atypical pseudoductular proliferation. The proliferating cells were probably of bile duct origin and exhibited atypia and mitoses. The pathogenetic mechanism may involve lipid peroxidation caused by free oxygen radicals derived from MEKP.
一名47岁男子意外摄入了过氧化甲乙酮（MEKP）在邻苯二甲酸二甲酯中的溶液，随后发生了致命的大面积肝小叶周边坏死。此类溶液含有约10%的活性氧。临床过程的特征为短暂心脏骤停、腹部烧伤、严重代谢性酸中毒、快速肝功能衰竭、横纹肌溶解和呼吸功能不全。4天后，因肝昏迷伴凝血功能障碍导致死亡。显微镜检查显示肝门周围大量肝坏死，并伴有非典型假胆管增生。增生的细胞可能起源于胆管，表现出异型性和有丝分裂。发病机制可能涉及MEKP产生的游离氧自由基引起的脂质过氧化。
