Publicação
A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis
| Resumo: | Abstract: Drug-induced liver injury is hardly diagnosed, considering not only the wide range of hepatotoxic substances but also the diversity of associated phenotypes and the absence of specific biomarkers. Symptom chronology, drug or toxic exposure, and temporal association help to establish the diagnosis. Exposure to isopropanol has known but rare toxic effects. We report the clinical case of a 33-year-old female hairdresser admitted to the hospital with fatigue, epigastric pain, and jaundice. She presented the following values: aspartate aminotransferase, 485 U/L; alanine transaminase, 908 U/L; ALP, 240 U/L; GGT, 370 U/L; total bilirubin, 3.5 mg/dL; and direct bilirubin, 2.1 mg/dL. Albumin, platelet, and INR values were normal. Structural, infectious, immune, and vascular causes were excluded. Liver biopsy was suggestive of toxic hepatitis. A possible association with ibuprofen intake was considered. The patient resumed professional activity, with fatigue and jaundice relapse, as well as a new liver enzyme increase, despite ibuprofen withdrawal. It was concluded that a new hair product containing isopropanol had recently been introduced. As soon as its professional use was discontinued, there was no recurrence of the symptoms. Given the temporal association between the development of acute hepatitis and the use of an isopropanol-containing product, liver toxicity by exposure to isopropanol was assumed. This substance is metabolized in the liver and toxicity may occur by ingestion, skin exposure, or inhalation, and it is described in cases of occupational or accidental exposure. The treatment is symptomatic and comprises toxic suspension. |
|---|---|
| Autores principais: | Santos,Daniela Soares |
| Outros Autores: | Nunes,Ana Luísa Luísa; Matos,Ana Luísa; Lai,Ana; Santos,Arsénio; Carvalho,Armando |
| Assunto: | Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | relatório |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Fundação para a Ciência e Tecnologia |
| Idioma: | inglês |
| Origem: | SciELO Portugal |
| _version_ | 1868441988226875392 |
|---|---|
| author | Santos,Daniela Soares |
| author2 | Nunes,Ana Luísa Luísa Matos,Ana Luísa Lai,Ana Santos,Arsénio Carvalho,Armando |
| author2_role | author author author author author |
| author_facet | Santos,Daniela Soares Nunes,Ana Luísa Luísa Matos,Ana Luísa Lai,Ana Santos,Arsénio Carvalho,Armando |
| author_role | author |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Santos,Daniela Soares\"},{\"Person.name\":\"Nunes,Ana Luísa Luísa\"},{\"Person.name\":\"Matos,Ana Luísa\"},{\"Person.name\":\"Lai,Ana\"},{\"Person.name\":\"Santos,Arsénio\"},{\"Person.name\":\"Carvalho,Armando\"}] |
| datacite.creators.creator.creatorName.fl_str_mv | Santos,Daniela Soares Nunes,Ana Luísa Luísa Matos,Ana Luísa Lai,Ana Santos,Arsénio Carvalho,Armando |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| datacite.titles.title.fl_str_mv | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| dc.creator.none.fl_str_mv | Santos,Daniela Soares Nunes,Ana Luísa Luísa Matos,Ana Luísa Lai,Ana Santos,Arsénio Carvalho,Armando |
| dc.format.none.fl_str_mv | text/html |
| dc.identifier.none.fl_str_mv | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000300198 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Sociedade Portuguesa de Gastrenterologia |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.source.none.fl_str_mv | GE-Portuguese Journal of Gastroenterology v.28 n.3 2021 |
| dc.subject.none.fl_str_mv | Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| dc.title.fl_str_mv | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_93fc |
| description | Abstract: Drug-induced liver injury is hardly diagnosed, considering not only the wide range of hepatotoxic substances but also the diversity of associated phenotypes and the absence of specific biomarkers. Symptom chronology, drug or toxic exposure, and temporal association help to establish the diagnosis. Exposure to isopropanol has known but rare toxic effects. We report the clinical case of a 33-year-old female hairdresser admitted to the hospital with fatigue, epigastric pain, and jaundice. She presented the following values: aspartate aminotransferase, 485 U/L; alanine transaminase, 908 U/L; ALP, 240 U/L; GGT, 370 U/L; total bilirubin, 3.5 mg/dL; and direct bilirubin, 2.1 mg/dL. Albumin, platelet, and INR values were normal. Structural, infectious, immune, and vascular causes were excluded. Liver biopsy was suggestive of toxic hepatitis. A possible association with ibuprofen intake was considered. The patient resumed professional activity, with fatigue and jaundice relapse, as well as a new liver enzyme increase, despite ibuprofen withdrawal. It was concluded that a new hair product containing isopropanol had recently been introduced. As soon as its professional use was discontinued, there was no recurrence of the symptoms. Given the temporal association between the development of acute hepatitis and the use of an isopropanol-containing product, liver toxicity by exposure to isopropanol was assumed. This substance is metabolized in the liver and toxicity may occur by ingestion, skin exposure, or inhalation, and it is described in cases of occupational or accidental exposure. The treatment is symptomatic and comprises toxic suspension. |
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| format | report |
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| identifier.url.fl_str_mv | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000300198 |
| instacron_str | SciELO |
| institution | Fundação para a Ciência e Tecnologia |
| instname_str | Fundação para a Ciência e Tecnologia |
| language | eng |
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| network_name_str | SciELO Portugal |
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| person_str_mv | Santos,Daniela Soares Nunes,Ana Luísa Luísa Matos,Ana Luísa Lai,Ana Santos,Arsénio Carvalho,Armando |
| publishDate | 2021 |
| publisher.none.fl_str_mv | Sociedade Portuguesa de Gastrenterologia |
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| spelling | A Case of Liver Injury after Exposure to Isopropanol: A Challenging DiagnosisSantos,Daniela SoaresNunes,Ana Luísa LuísaMatos,Ana LuísaLai,AnaSantos,ArsénioCarvalho,ArmandoHepatotoxicityIsopropanolHairdresserDrug-induced liver injuryOccupational liver diseaseopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000300198URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000300198URLHasVersion2021-06-01Abstract: Drug-induced liver injury is hardly diagnosed, considering not only the wide range of hepatotoxic substances but also the diversity of associated phenotypes and the absence of specific biomarkers. Symptom chronology, drug or toxic exposure, and temporal association help to establish the diagnosis. Exposure to isopropanol has known but rare toxic effects. We report the clinical case of a 33-year-old female hairdresser admitted to the hospital with fatigue, epigastric pain, and jaundice. She presented the following values: aspartate aminotransferase, 485 U/L; alanine transaminase, 908 U/L; ALP, 240 U/L; GGT, 370 U/L; total bilirubin, 3.5 mg/dL; and direct bilirubin, 2.1 mg/dL. Albumin, platelet, and INR values were normal. Structural, infectious, immune, and vascular causes were excluded. Liver biopsy was suggestive of toxic hepatitis. A possible association with ibuprofen intake was considered. The patient resumed professional activity, with fatigue and jaundice relapse, as well as a new liver enzyme increase, despite ibuprofen withdrawal. It was concluded that a new hair product containing isopropanol had recently been introduced. As soon as its professional use was discontinued, there was no recurrence of the symptoms. Given the temporal association between the development of acute hepatitis and the use of an isopropanol-containing product, liver toxicity by exposure to isopropanol was assumed. This substance is metabolized in the liver and toxicity may occur by ingestion, skin exposure, or inhalation, and it is described in cases of occupational or accidental exposure. The treatment is symptomatic and comprises toxic suspension.Sociedade Portuguesa de GastrenterologiaGE-Portuguese Journal of Gastroenterology v.28 n.3 2021text/htmlengreporthttp://purl.org/coar/resource_type/c_93fcother research product |
| spellingShingle | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis Santos,Daniela Soares Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| status | SINGLETON |
| subject.fl_str_mv | Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| title | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| title_full | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| title_fullStr | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| title_full_unstemmed | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| title_short | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| title_sort | A Case of Liver Injury after Exposure to Isopropanol: A Challenging Diagnosis |
| topic | Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| topic_facet | Hepatotoxicity Isopropanol Hairdresser Drug-induced liver injury Occupational liver disease |
| url | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000300198 |
| visible | 1 |