Halothane hepatitis in Iran: a review of 59 cases.
OBJECTIVE
To study halothane hepatitis (HH) in Iran and its associated risk factors.


METHODS
We retrospectively studied files of all cases diagnosed with HH referred to three referral hospitals and four private centers in Iran from April 1994 to September 2006. Information on age at surgery, gender, medications history, obesity, history of previous exposure, previous reaction to halothane, familial history, type of surgery, perioperative hypoxia or sepsis, morbidity and mortality were recorded and analyzed.


RESULTS
A total of 59 cases were identified. Forty-eight (81%) were women. The median age at the time of surgery was 44 years (range, 18 to 80 years). Sixty percent of patients were above 40-year-old. Obesity was observed in 22.2%. Previous history of exposures to halothane was noted in 61% of which 50% had history of post-exposure reaction. Coronary artery bypass graft (CABG), cholecystectomy, and cosmetic surgeries (mainly weight reduction) were the most frequent surgeries. The mortality rate was 12.2%. In patients developing encephalopathy, it was as high as 50%.


CONCLUSIONS
HH remains an important cause of morbidity and mortality in centers still using this anesthetic. However, a large percentage of these cases could have been avoided. To lessen occurrence of further cases of HH, the authors suggest that in female patients having a history of surgery (or delivery) with general anesthesia, the use of halothane should be absolutely avoided. Utilization of proper substitutes in adults' anesthesia is advocated.
Eghtesadi-Araghi
Payam
P
Digestive Disease Research Center, Shariati Hospital, North Karegar Avenue, Medical Sciences/University of Tehran, Tehran 14117, Iran. payam_eghtesadi@yahoo.com
Sohrabpour
Amirali
A
Vahedi
Homayoon
H
Saberi-Firoozi
Mehdi
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D000075202:Contraindications; D005260:Female; D006221:Halothane / Q000009:adverse effects*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
D018685:Anesthetics, Inhalation; D006221:Halothane
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