Clinical and pathological characteristics of hepatotoxicity associated with occupational exposure to dimethylformamide

Carrie A. Redlich, A. Brian West, Lora Fleming, Lawrence D. True, Mark R. Cullen, Caroline A. Riely

Research output: Contribution to journalArticle

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Abstract

The clinical characteristics, laboratory results, and liver biopsy findings of seven workers with toxic liver injury associated with exposure to several solvents, including substantial levels of the widely used solvent dimethylformamide, are presented. Three patients had short exposure (less than 3 months), four long exposure (greater than 1 year). Among those with brief exposure, symptoms included anorexia, abdominal pain, and disulfiramtype reaction. Aminotransferases were markedly elevated with the ratio of alanine aminotransferase to aspartate aminotransferase always greater than 1. Liver biopsy showed focal hepatocellular necrosis and microvesicular steatosis with prominence of smooth endoplasmic reticulum, complex lysosomes, and pleomorphic mitochondria with crystalline inclusions. Among workers with long exposure, symptoms were minimal and enzyme elevations modest. Biopsies showed macrovesicular steatosis, pleomorphic mitochondria without crystalloids, and prominent smooth endoplasmic reticulum, but no evidence of persisting acute injury or fibrosis. Abnormal aminotransferases in both groups may persist for months after removal from exposure, but progression to cirrhosis in continually exposed workers was not observed. We conclude that exposure of these workers to solvents, chiefly dimethylformamide, may result in two variants of toxic liver injury with subtle clinical, laboratory, and morphological features. This may be readily overlooked if occupational history and biopsy histology are not carefully evaluated.

Original languageEnglish
Pages (from-to)748-757
Number of pages10
JournalGastroenterology
Volume99
Issue number3
StatePublished - Dec 1 1990
Externally publishedYes

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Dimethylformamide
Occupational Exposure
Biopsy
Smooth Endoplasmic Reticulum
Poisons
Liver
Transaminases
Mitochondria
Wounds and Injuries
Fibrosis
Anorexia
Aspartate Aminotransferases
Lysosomes
Alanine Transaminase
Abdominal Pain
Histology
Necrosis
Enzymes

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Redlich, C. A., West, A. B., Fleming, L., True, L. D., Cullen, M. R., & Riely, C. A. (1990). Clinical and pathological characteristics of hepatotoxicity associated with occupational exposure to dimethylformamide. Gastroenterology, 99(3), 748-757.

Clinical and pathological characteristics of hepatotoxicity associated with occupational exposure to dimethylformamide. / Redlich, Carrie A.; West, A. Brian; Fleming, Lora; True, Lawrence D.; Cullen, Mark R.; Riely, Caroline A.

In: Gastroenterology, Vol. 99, No. 3, 01.12.1990, p. 748-757.

Research output: Contribution to journalArticle

Redlich, CA, West, AB, Fleming, L, True, LD, Cullen, MR & Riely, CA 1990, 'Clinical and pathological characteristics of hepatotoxicity associated with occupational exposure to dimethylformamide', Gastroenterology, vol. 99, no. 3, pp. 748-757.
Redlich CA, West AB, Fleming L, True LD, Cullen MR, Riely CA. Clinical and pathological characteristics of hepatotoxicity associated with occupational exposure to dimethylformamide. Gastroenterology. 1990 Dec 1;99(3):748-757.
Redlich, Carrie A. ; West, A. Brian ; Fleming, Lora ; True, Lawrence D. ; Cullen, Mark R. ; Riely, Caroline A. / Clinical and pathological characteristics of hepatotoxicity associated with occupational exposure to dimethylformamide. In: Gastroenterology. 1990 ; Vol. 99, No. 3. pp. 748-757.
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