"Hepatitic flare", asthenia, peripheral polyneuropathy and diffuse liver steatosis in a hepatitis C virus asymptomatic chronic carrier.
In July 2000, a 62-year-old female, with a ten-year history of chronic hepatitis C virus infection and persistently normal aspartate amino-transferase and alanine aminotransferase levels, presented with asthenia, weight loss, peripheral polyneuropathy and increased levels of aspartate aminotransferase (8 times upper normal limit), alanine aminotransferase (10 times upper normal limit) and gamma glutamyl-transferase (6 times upper normal limit). The ultrasound findings were consistent with massive liver steatosis. The patient had been previously diagnosed elsewhere as having hepatitis C virus-related "hepatitic flare" with neurological involvement related to concomitant mixed type-III cryoglobulinaemia. However intense exposure to trichloroethylene since April 2000 was revealed and liver histology was fully consistent with non-alcoholic steatohepatitis. The pathogenetic role of the solvent was definitely supported by the complete clinical and biochemical remission within six months of trichloroethylene withdrawal.
Caprioli
F
F
Cattedra di Gastroenterologia, IRCCS Ospedale Maggiore, Milan, Italy.
Pometta
R
R
Visentin
S
S
Massironi
S
S
Conte
D
D
D001247:Asthenia / Q000139:chemically induced*; D002353:Carrier State; D005234:Fatty Liver / Q000139:chemically induced*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D012997:Solvents / Q000009:adverse effects; D014241:Trichloroethylene / Q000009:adverse effects
D012997:Solvents; D014241:Trichloroethylene