Fukushima Hirofumi, Kubo Yasuhiko, Matsugaki Satoru, Sakemi Ryosuke, Sakakibara Shigenari, Morimitsu Yosuke
Department of Gastroenterology, Tobata Kyoritsu Hospital.
Division of Pathology, Tobata Kyoritsu Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2019;116(11):944-951. doi: 10.11405/nisshoshi.116.944.
This case report presents two males with drug-induced liver injury acquired from working at a glass factory dealing with silica and 2,2-dichloro-1,1,1-trifluoroethane (HCFC-123). Within one month of work, both patients presented with fever, icterus with liver dysfunction, and eosinophilia. Case 1 had experienced recurrence of symptoms twice while working and showed positive results for the drug-induced lymphocyte stimulation test (DLST). Meanwhile, case 2 was diagnosed by liver biopsy and clinical course but was negative for DLST. Hazard of exposure to non-crystalline silica is low, but drug-induced liver injury after exposure to HCFC-123 has been reported. Allergic liver injury is also caused by chemical substances;however, the insight into whether this injury is caused by exposure to silica or HCFC-123 remains unclear. Further studies are required to examine the influence of silica and HCFC-123 on drug-induced liver injury among glass-factory employees.
本病例报告介绍了两名男性,他们在一家处理二氧化硅和2,2 - 二氯 - 1,1,1 - 三氟乙烷(HCFC - 123)的玻璃厂工作时患上了药物性肝损伤。在工作一个月内,两名患者均出现发热、黄疸伴肝功能障碍以及嗜酸性粒细胞增多。病例1在工作期间症状复发两次,药物诱导淋巴细胞刺激试验(DLST)结果呈阳性。与此同时,病例2通过肝活检和临床病程确诊,但DLST结果为阴性。接触非晶态二氧化硅的危害较低,但已有接触HCFC - 123后发生药物性肝损伤的报道。过敏性肝损伤也由化学物质引起;然而,这种损伤是否由接触二氧化硅或HCFC - 123所致仍不清楚。需要进一步研究以考察二氧化硅和HCFC - 123对玻璃厂员工药物性肝损伤的影响。