A Case of Autoimmune Hepatitis after Occupational Exposure to N,N-Dimethylformamide.

Journal of Korean Medical Science
Boo Ok JangSook Hyang Jeong

Abstract

N,N-dimethylformamide (DMF), a widely used solvent in the chemical industry, is known to induce toxic hepatitis. However, there have been no reported cases of DMF-associated autoimmune hepatitis. A 31-year-old healthy man working at a glove factory since July 2015 had intermittently put his bare hands into a diluted DMF solution for his first 15 days at work. After 2 months, he felt nausea, fatigue, and hand cramping, and a jaundice followed. His laboratory findings showed positive autoantibodies and elevated immunoglobulin G (IgG), and his liver biopsy pathology was typical of autoimmune hepatitis (AIH). Prednisolone and azathioprine therapy began, and he recovered rapidly without adverse events. Though his liver chemistry was normalized, the IgG level remained persistently upper normal range. His 2nd liver biopsy performed in April 2019 showed mild portal activity, and he was well under a low dose immunosuppressive therapy up to April 2020. This case warns of the hazard of occupational exposure to DMF, and clinicians should be aware of DMF-related AIH for timely initiation of immunosuppressive therapy.

References

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Sep 3, 2002·Yonsei Medical Journal·Sang Baek KohSei Jin Chang
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Jul 27, 2011·Environmental Toxicology and Pharmacology·Ding RuiYang Yongjian
May 7, 2015·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Tian T YeongSumita Verma
Sep 4, 2015·Forensic Science, Medicine, and Pathology·Hui ZhangYiwu Zhou
Jan 9, 2018·Clinical and Molecular Hepatology·Sook-Hyang Jeong
Apr 13, 2018·Nature Reviews. Disease Primers·Giorgina Mieli-VerganiAldo J Montano-Loza
Dec 24, 2018·Chemico-biological Interactions·Ming-Jun Li, Tao Zeng

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Methods Mentioned

BETA
biopsy

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Autoimmune Hepatitis

Autoimmune hepatitis formerly called lupoid hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells causing the liver to be inflamed. Discover the latest research on autoimmune hepatitis here.

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