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接触加湿器消毒剂后发生的中毒性肝炎:病例系列报告

Toxic hepatitis after exposure to humidifier disinfectant: A case series report.

作者信息

Kim Hyung Doo, Kim Hwan-Cheol, Leem Jong-Han

机构信息

Infectious Disease Control Division, Incheon, Republic of Korea.

Departement of Occupational and Environmental Medicine Inha University College of Medicine, Incheon, Republic of Korea.

出版信息

Environ Anal Health Toxicol. 2023 Mar;38(1):e2023002-0. doi: 10.5620/eaht.2023002. Epub 2023 Mar 6.

Abstract

Health damage from humidifier disinfectants is an unprecedented environmental health disaster. Humidifier disinfectants were used broadly in Korea from 1994 to 2011. Most studies have focused on respiratory problems because of the exposure route and primary respiratory symptoms. This overlooks the previous research results that humidifier disinfectants could move to extrapulmonary organs and induce toxic effects. Thus, the objective of this study was to examine toxic hepatitis cases developed after inhaling humidifier disinfectant. We focused on the indications of toxic hepatitis in two pediatric cases and one female adult case. All patients were exposed to humidifier disinfectants in a residential space. These disinfectants all contained polyhexamethylene guanidine (PHMG). Rapid increases in blood hepatic enzyme levels were seen. Two patients were discharged after treatment. Death occurred in one patient who was diagnosed with fulminant hepatitis of unknown cause. This human case series study supports prior knowledge that hepatotoxicity can occur by inhaling humidifier disinfectant.

摘要

加湿器消毒剂造成的健康损害是一场前所未有的环境卫生灾难。1994年至2011年期间,加湿器消毒剂在韩国被广泛使用。由于接触途径和主要呼吸道症状,大多数研究都集中在呼吸道问题上。这忽视了先前的研究结果,即加湿器消毒剂可能转移到肺外器官并产生毒性作用。因此,本研究的目的是调查吸入加湿器消毒剂后发生的中毒性肝炎病例。我们重点关注了两例儿科病例和一例成年女性病例中的中毒性肝炎迹象。所有患者均在居住空间接触了加湿器消毒剂。这些消毒剂均含有聚六亚甲基胍(PHMG)。血液中肝酶水平迅速升高。两名患者经治疗后出院。一名被诊断为不明原因暴发性肝炎的患者死亡。这个人类病例系列研究支持了先前的认识,即吸入加湿器消毒剂可导致肝毒性。

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