title: Trichloroethylene hypersensitivity syndrome: a disease of fatal outcome.
abstract: Trichloroethylene is commonly used as an industrial solvent and degreasing agent. The clinical features of acute and chronic intoxication with trichloroethylene are well-known and have been described in many reports, but hypersensitivity syndrome caused by trichloroethylene is rarely encountered. For managing patients with trichloroethylene hypersensitivity syndrome, avoiding trichloroethylene and initiating glucocorticoid have been generally accepted. Generally, glucocorticoid had been tapered as trichloroethylene hypersensitivity syndrome had ameliorated. However, we encountered a typical case of trichloroethylene hypersensitivity syndrome refractory to high dose glucocorticoid treatment. A 54-year-old Korean man developed jaundice, fever, red sore eyes, and generalized erythematous maculopapular rashes. A detailed history revealed occupational exposure to trichloroethylene. After starting intravenous methylprednisolone, his clinical condition improved remarkably, but we could not reduce prednisolone because his liver enzyme and total bilirubin began to rise within 2 days after reducing prednisolone under 60 mg/day. We recommended an extended admission for complete recovery, but the patient decided to leave the hospital against medical advice. The patient visited the emergency department due to pneumonia and developed asystole, which did not respond to resuscitation.
authors.affiliation: Department of Internal Medicine, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
authors.forename: Hyun Gul
authors.initials: HG
authors.lastname: Jung
authors.forename: Hyung Hun
authors.initials: HH
authors.lastname: Kim
authors.forename: Bong Gun
authors.initials: BG
authors.lastname: Song
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Kim
mesh_terms: D009783:Dermatitis, Occupational / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D012997:Solvents / Q000633:toxicity*; D014241:Trichloroethylene / Q000633:toxicity*
chemical_list: D012997:Solvents; D014241:Trichloroethylene