Acute liver failure caused by occupational exposure to HCFC-123: Two case reports

Medicine
Hun Jee ChoeJin-Wook Kim

Abstract

Hydrochlorofluorocarbon 123 (HCFC-123, Freon123; 2,2-dichloro-1,1,1-trifluoroethane) has been widely used in refrigeration and heat-transfer applications as a substitute for chlorofluorocarbons due to its lower ozone-depleting potentials. Occupational exposure to HCFC-123 may cause mild reversible hepatoxicity, but no fatal cases have been reported yet. In this report, we present cases of severe hepatitis with fatal outcome by HCFC-123. Two industrial workers from a manufacturing factory of fire extinguishers which use HCFC-123 were presented with diarrhea, fever, myalgia, and jaundice. Patients had been repeatedly exposed to the liquid form of HCFC-123 for the past three weeks before flare of symptoms. The blood biochemistry tests showed acute cholestatic hepatitis and liver biopsy findings indicated inflammatory hepatocellular injury. The diagnosis of HCFC-123 induced hepatitis was made. The treatment for both patients were generally supportive. The second patient went through hemodialysis, ventilatory care, and artificial liver support therapy (molecular adsorbent recirculating system) at intensive care unit. One patient recovered uneventfully, whereas the other patient showed rapid deterioration leading to acute liver failu...Continue Reading

References

Jan 1, 1993·Pharmacology & Therapeutics·J GutJ Huwyler
Aug 24, 1999·Applied Occupational and Environmental Hygiene·T TakebayashiK Omae
Jul 20, 2010·Lancet·William BernalJulia Wendon
Jun 22, 2012·World Journal of Gastroenterology : WJG·Giulia MalaguarneraMariano Malaguarnera
Dec 15, 2012·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·William R ProctorLance R Pohl
Jul 11, 2014·World Journal of Gastroenterology : WJG·Halina Cichoż-Lach, Agata Michalak
Dec 10, 2014·Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi·Y M KanC K Loo
Oct 12, 2016·Journal of Occupational Health
Apr 19, 2017·Journal of Hepatology·UNKNOWN European Association for the Study of the Liver. Electronic address: easloffice@easloffice.euMauro Bernardi

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